Active NPI
Ponciano P Palmiery, M.D.
- Pediatrics Physician
- Harrison, NJ
National Provider Identifier
1114005329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA03479100
- Practice address
- 332 Harrison Ave
Harrison, NJ 07029-1775 - Phone
- (973) 484-2584
- Fax
- (973) 484-9216
- NPI assigned
- Nov 2, 2006
- Last updated
- Dec 3, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 25MA03479100 | NJ | Primary |
Addresses
Primary practice location
332 Harrison Ave
Harrison, NJ 07029-1775
Mailing address
332 Harrison Ave
Harrison, NJ 07029-1775
Phone (973) 484-2584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1793306 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03479100 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harrison Medical Group LLC | Pediatrics | Current | Accepting new patients |
| Harrison Pediatric Care Center, P.a. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Harrison, NJ
- NPI 1225163678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291334400000",
"number": "1114005329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 HARRISON AVE",
"city": "HARRISON",
"state": "NJ",
"postal_code": "070291775",
"telephone_number": "973-484-2584",
"fax_number": "973-484-9216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 HARRISON AVE",
"city": "HARRISON",
"state": "NJ",
"postal_code": "070291775",
"telephone_number": "973-484-2584",
"fax_number": "973-484-9216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMIERY",
"first_name": "PONCIANO",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2010-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA03479100",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1793306",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrison, NJ
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- Nna of Harrison, L.L.C. (Renex Dialysis Clinic of Harrison)
- Optical Palace of Harrison LLC.
- Optical Palace of Hudson LLC
- Amit K Patel, PHARMACIST
- Teena Payyanattu, RPH
- Walter Perez, MD
- Pharmacy Plus & Surgical Supplies LLC
- Pharmacy Plus & Surgical Supplies LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.