Provider Demographics
NPI:1689413080
Name:PALESTINA, DANIELLE (ATC, RN)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PALESTINA
Suffix:
Gender:F
Credentials:ATC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3008
Mailing Address - Country:US
Mailing Address - Phone:973-600-3143
Mailing Address - Fax:
Practice Address - Street 1:188 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3008
Practice Address - Country:US
Practice Address - Phone:973-600-3143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22604700163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse