Provider Demographics
NPI:1801285747
Name:PALMTREE MEDICAL CARE LLC
Entity type:Organization
Organization Name:PALMTREE MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYE
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-951-0897
Mailing Address - Street 1:2 E HARTSHORN DR
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1630
Mailing Address - Country:US
Mailing Address - Phone:201-759-4411
Mailing Address - Fax:973-616-7338
Practice Address - Street 1:2 E HARTSHORN DR
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-1630
Practice Address - Country:US
Practice Address - Phone:201-759-4411
Practice Address - Fax:973-616-7338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-15
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1356371819OtherINDIVIDUAL NPI