Doctor Name: | MISS ANNALISA JOANN PALAZZOLO |
NPI Number: | 1073902052 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | |
Business Practice Address: | 333 Budlong Rd Cranston, RI - 029206337 |
Business Phone Number: | 5869434530 |
Business Fax Number: | |
Mailing Address: | 105 4th St, Apt 1 PROVIDENCE |
State: | RI |
Postal Code: | 029062803 |
Phone Number: | 5866122200 |
Fax Number: | |
NPI Enumeration Date: | 01/14/2015 |
NPI Last Update Date: | 01/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |