Provider Demographics
NPI:1831152297
Name:PALMATEER, DANIEL RICHARD (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:RICHARD
Last Name:PALMATEER
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 1:80 E MAIN ST - SUITE 104
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1403
Mailing Address - Country:US
Mailing Address - Phone:315-386-8184
Mailing Address - Fax:
Practice Address - Street 1:80 E MAIN ST - SUITE 104
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1403
Practice Address - Country:US
Practice Address - Phone:315-386-8184
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01090413Medicaid
BB4887Medicare ID - Type Unspecified
NY01090413Medicaid