Provider Demographics
NPI:1861427015
Name:PALENCIA, DAVID JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSE
Last Name:PALENCIA
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 1:3187 STEINWAY ST
Mailing Address - Street 2:THIRD FLOOR, SUITE 7
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-9816
Mailing Address - Country:US
Mailing Address - Phone:718-626-8500
Mailing Address - Fax:
Practice Address - Street 1:3187 STEINWAY ST
Practice Address - Street 2:THIRD FLOOR, SUITE 7
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-9816
Practice Address - Country:US
Practice Address - Phone:718-626-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine