Basic Information
Provider Information
NPI: 1174736896
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALMA
FirstName: LILIANA
MiddleName: I.
NamePrefix: MS.
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 59 E 17TH ST APT 2
Address2:  
City: PATERSON
State: NJ
PostalCode: 075241514
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 150 NEW PROVIDENCE RD
Address2:  
City: MOUNTAINSIDE
State: NJ
PostalCode: 070922590
CountryCode: US
TelephoneNumber: 9082333720
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01222600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home