Provider Demographics
NPI:1063574929
Name:PALMAROZZO, PAUL MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MICHAEL
Last Name:PALMAROZZO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CAREY AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BUTLER
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-1407
Mailing Address - Country:US
Mailing Address - Phone:973-838-8885
Mailing Address - Fax:
Practice Address - Street 1:9 CAREY AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BUTLER
Practice Address - State:NJ
Practice Address - Zip Code:07405-1407
Practice Address - Country:US
Practice Address - Phone:973-838-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00175800213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1091204Medicaid
NJ449999Medicare ID - Type UnspecifiedPROVIDER ID NUMBER
NJT45101Medicare UPIN