Provider Demographics
NPI:1720713878
Name:WHITE PLAINS PHYSICIAN SERVICES, P.C.
Entity Type:Organization
Organization Name:WHITE PLAINS PHYSICIAN SERVICES, P.C.
Other - Org Name:
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:914-681-1210
Mailing Address - Fax:
Practice Address - Street 1:600 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1635
Practice Address - Country:US
Practice Address - Phone:914-723-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHITE PLAINS PHYSICIAN SERVICES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDMERCOtherDMERC