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Specialty details in registry · Mamaroneck, NY

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At a glance

845 Palmer Ave, Mamaroneck, NY 10543-2406

NPPES record updated Apr 11, 2018. Public records can lag behind changes at a practice.

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Practice location

845 Palmer Ave Attn Medical Department
Mamaroneck, NY 10543-2406
Professional details: NPI, taxonomy & registry record
NPI1275608390
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
207RG0300X
Enumeration date
Nov 22, 2006
Record updated
Apr 11, 2018
More registry details
Provider type
Organization · Type 2
Other reported name
<UNAVAIL>

Reported taxonomies and licenses

Specialty details in registry

207RG0300X · Primary

License reported: 5909302N NY

Nurse Practitioner

363L00000X

License reported: 5909302N NY

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

845 Palmer Ave
Attn Medical Department
Mamaroneck, NY 10543-2406
Phone
(914) 864-5856
Mailing address
845 PALMER AVE
ATTN MEDICAL DEPARTMENT
MAMARONECK, NY 105432406
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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