Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT009956L | PA |
N | 2251G0304X | Physical Therapist - Geriatrics | PT009956L | PA |
NPI | 1275805442 |
---|---|
Provider Name | Dr. Kerstin M Palombaro |
First Address | Chester, PA 19013-5700 |
Second Address | Chester, PA 19013-5506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2012 |
Last Update Date | 03/02/2012 |