Provider Demographics
NPI:1356392468
Name:PALERMO, MARCO LUIGI (DPT)
Entity type:Individual
Prefix:MR
First Name:MARCO
Middle Name:LUIGI
Last Name:PALERMO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Mailing Address - Street 1:99 JERICHO TPKE
Mailing Address - Street 2:STE 100
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1015
Mailing Address - Country:US
Mailing Address - Phone:516-280-8044
Mailing Address - Fax:516-280-8045
Practice Address - Street 1:99 JERICHO TPKE
Practice Address - Street 2:STE 100
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-1015
Practice Address - Country:US
Practice Address - Phone:516-280-8044
Practice Address - Fax:516-280-8045
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-13
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0257731225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist