Provider Demographics
NPI:1659457265
Name:PALMERI, SEBASTIAN T (MD)
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:T
Last Name:PALMERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SUMMERHILL RD
Mailing Address - Street 2:SUITE 4 & 5
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4911
Mailing Address - Country:US
Mailing Address - Phone:732-238-6440
Mailing Address - Fax:732-651-1431
Practice Address - Street 1:172 SUMMERHILL RD
Practice Address - Street 2:SUITE 4 & 5
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4911
Practice Address - Country:US
Practice Address - Phone:732-238-6440
Practice Address - Fax:732-651-1431
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52870174400000X
NJ25MA05287000207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1064383OtherHORIZON NJ HEALTH
NJF04682OtherHEALTHNET
NJ060015480OtherRR MCR PTAN
NJ1075608Medicaid
NJ14447OtherBEECH STREET
NJ2431182OtherAETNA
NJ15632OtherUNIVERSITY HEALTH PLANS
NJP511095OtherOXFORD
NJ780222259OtherHORIZON
NJ9070857008OtherCIGNA
NJF04682OtherHEALTHNET
NJ1064383OtherHORIZON NJ HEALTH
NJ9070857008OtherCIGNA