Provider Demographics
NPI:1396486403
Name:PALAZZOLO RAY, ANDREA MARIE ELIZABETH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE ELIZABETH
Last Name:PALAZZOLO RAY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ESKENAZI AVE RM F2-163
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5187
Mailing Address - Country:US
Mailing Address - Phone:317-278-5835
Mailing Address - Fax:317-880-3602
Practice Address - Street 1:720 ESKENAZI AVE RM F2-163
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5187
Practice Address - Country:US
Practice Address - Phone:317-278-5835
Practice Address - Fax:317-880-3602
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program