Basic Information
| Provider Information | |||||||||
| NPI: | 1871012849 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALMIERI | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RADT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6572 MARY ELLEN AVE | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914011327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155278409 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8330 LANKERSHIM BLVD | ||||||||
| Address2: | |||||||||
| City: | NORTH HOLLYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 916051615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182557030 | ||||||||
| FaxNumber: | 8187689877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2017 | ||||||||
| LastUpdateDate: | 09/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.