Provider Demographics
NPI:1811941123
Name:PALMERI, PHILIP MARK (DPM)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MARK
Last Name:PALMERI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3636
Mailing Address - Country:US
Mailing Address - Phone:516-326-4454
Mailing Address - Fax:516-326-9605
Practice Address - Street 1:925 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3636
Practice Address - Country:US
Practice Address - Phone:516-326-4454
Practice Address - Fax:516-326-9605
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003784213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT51300Medicare UPIN