1972562254 NPI number — DR. ANA KATARINA PALMIERI M.D.

Table of content: DR. ANA KATARINA PALMIERI M.D. (NPI 1972562254)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972562254 NPI number — DR. ANA KATARINA PALMIERI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMIERI
Provider First Name:
ANA
Provider Middle Name:
KATARINA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972562254
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9616
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELFAST
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04915-9616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-850-1150
Provider Business Mailing Address Fax Number:
901-850-1102

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
472 W POPLAR AVE
Provider Second Line Business Practice Location Address:
200
Provider Business Practice Location Address City Name:
COLLIERVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38017-2538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-850-1150
Provider Business Practice Location Address Fax Number:
901-850-1102
Provider Enumeration Date:
03/23/2006

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: 225100000X , with the licence number:  1717 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , with the licence number: 29991 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200046147 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3839531 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 612005500 . This is a "WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7130040 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200046147 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 4049550 . This is a "BCBST" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 00122384 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 411370497A . This is a "ADVANCED HEALTH SYSTEMS" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 8381196 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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