Provider Demographics
NPI:1649442658
Name:FRANCIS PALUMBO BUILDER, INC
Entity type:Organization
Organization Name:FRANCIS PALUMBO BUILDER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-567-4478
Mailing Address - Street 1:34 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1329
Mailing Address - Country:US
Mailing Address - Phone:631-567-4478
Mailing Address - Fax:631-567-4009
Practice Address - Street 1:34 HENRY ST
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1329
Practice Address - Country:US
Practice Address - Phone:631-567-4478
Practice Address - Fax:631-567-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02501953Medicaid