1285990861 NPI number — DR. KATHERINE LUDLOW PALMEROLA MD

Table of content: DR. KATHERINE LUDLOW PALMEROLA MD (NPI 1285990861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285990861 NPI number — DR. KATHERINE LUDLOW PALMEROLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMEROLA
Provider First Name:
KATHERINE
Provider Middle Name:
LUDLOW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUDLOW
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
DODGE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285990861
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
276 1ST AVE APT 10F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10009-1860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-499-0169
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
622 W 168TH ST
Provider Second Line Business Practice Location Address:
PH 16-29
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3720
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-2376
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VE0102X , with the licence number: ME138533 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 276378 . This is a "NEW YORK STATE OFFICE OF THE PROFESSIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: ME138533 . This is a "FLORIDA BOARD OF MEDICINE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com