Provider Demographics
NPI:1790523496
Name:PALMER, ZACHARY THOMAS
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:THOMAS
Last Name:PALMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238B TOLLAND TPKE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-5701
Mailing Address - Country:US
Mailing Address - Phone:860-643-2719
Mailing Address - Fax:
Practice Address - Street 1:238B TOLLAND TPKE
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-5701
Practice Address - Country:US
Practice Address - Phone:860-643-2719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT503237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist