Provider Demographics
NPI:1023628963
Name:PAUL F PALUMBO
Entity type:Organization
Organization Name:PAUL F PALUMBO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:PALUMBO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-723-0104
Mailing Address - Street 1:421 BROAD ST STE 14
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-1210
Mailing Address - Country:US
Mailing Address - Phone:315-271-9346
Mailing Address - Fax:315-507-2449
Practice Address - Street 1:421 BROAD ST STE 14
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-1210
Practice Address - Country:US
Practice Address - Phone:315-271-9346
Practice Address - Fax:315-507-2449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty