Provider Demographics
NPI:1396529442
Name:WHITE PLAINS PHYSICIAN SERVICES
Entity type:Organization
Organization Name:WHITE PLAINS PHYSICIAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-681-1210
Mailing Address - Street 1:PO BOX 412931
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2931
Mailing Address - Country:US
Mailing Address - Phone:844-363-0801
Mailing Address - Fax:
Practice Address - Street 1:79 E POST RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5008
Practice Address - Country:US
Practice Address - Phone:914-849-3488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE PLAINS PHYSICIAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-21
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty