Provider Demographics
NPI:1932152774
Name:PALMERI-NAMAN, KIM (PA)
Entity Type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:PALMERI-NAMAN
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:PRACTICE ASSOCITES MEDICAL GROUP
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:973-656-6280
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:211 MOUNTAIN AVE
Practice Address - Street 2:ASSOCITES IN CARDIOVASCULAR DISEASE
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-2221
Practice Address - Country:US
Practice Address - Phone:973-467-0005
Practice Address - Fax:973-912-8989
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00037000363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ226915U77Medicare PIN
S76309Medicare UPIN