Provider Demographics
NPI:1730540105
Name:ANDREW C PALERMO DDS PC
Entity type:Organization
Organization Name:ANDREW C PALERMO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:C
Authorized Official - Last Name:PALERMO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:631-368-2882
Mailing Address - Street 1:2 ROMANY WAY
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5118
Mailing Address - Country:US
Mailing Address - Phone:631-368-2882
Mailing Address - Fax:631-368-0864
Practice Address - Street 1:2 ROMANY WAY
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-5118
Practice Address - Country:US
Practice Address - Phone:631-368-2882
Practice Address - Fax:631-368-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-14
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty