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Individual

KHADIJA PALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3924 E TREMONT AVE, BRONX, NY 10465-2900
(718) 409-6500
Mailing address
3924 EAST TREMONT AVENUE, BRONX, NY 10465
(718) 409-6500

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
7436141
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8564
SOCIAL SECURITY NUMBER
NY
Enumeration date
10/26/2011
Last updated
10/26/2011
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