Provider Demographics
NPI:1174059430
Name:PALMOZE, ANTHONY SCOTT
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:SCOTT
Last Name:PALMOZE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PODUNK CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-4337
Mailing Address - Country:US
Mailing Address - Phone:617-852-8661
Mailing Address - Fax:
Practice Address - Street 1:35 CONGRESS ST
Practice Address - Street 2:SUITE 214
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5529
Practice Address - Country:US
Practice Address - Phone:978-542-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health