Provider Demographics
NPI:1265870612
Name:PALLADINO, DONALD SAMUEL JR (RN)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:SAMUEL
Last Name:PALLADINO
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FOREST ST
Mailing Address - Street 2:#2L
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-1377
Mailing Address - Country:US
Mailing Address - Phone:617-290-4698
Mailing Address - Fax:
Practice Address - Street 1:20 FOREST ST
Practice Address - Street 2:#2L
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966-1377
Practice Address - Country:US
Practice Address - Phone:617-290-4698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2883623163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse