Individual
LUCY PALOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1575 BEAM AVE, MAPLEWOOD, MN 55109-1126
(612) 863-6590
Mailing address
800 E 28TH ST # MR 11112, MINNEAPOLIS, MN 55407-3723
(612) 863-6590
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
46394
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091660900
—
MN
01
—
46394
MN MEDICAL LICENSE
—
Enumeration date
03/18/2006
Last updated
03/17/2018
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