| Doctor Name: | JOHN PALERMO |
| NPI Number: | 1033143995 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHYSICAN ASSISTANT |
| License Number: | 006768 |
| Business Practice Address: | 55 Northern Blvd Ste 103 Great Neck, NY - 110214058 |
| Business Phone Number: | 5164669300 |
| Business Fax Number: | 5164669353 |
| Mailing Address: | 369 East Main Street, Suite 3 EAST ISLIP |
| State: | NY |
| Postal Code: | 117302800 |
| Phone Number: | 6315814500 |
| Fax Number: | 6315811689 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 006768 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |