IndividualActive
Ebenezer Vander Pallen, RN
NPI 1760906143 · Nuclear Imaging & Therapy Physician · Staten Island, NY
Provider details
- NPI number
- 1760906143
- Entity type
- Individual
- Primary specialty
- Nuclear Imaging & Therapy PhysicianAllopathic & Osteopathic Physicians
- Credential
- RN
- Sex
- Male
- Sole proprietor
- Yes
- License
- 720270 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1366 Victory Blvd # B
Staten Island, NY 10301-3907
Phone: (718) 442-8351
Approximate (ZIP-level) locationGet directions
Mailing address
1491 Macombs Rd Apt 8d
Bronx, NY 10452-2145
Registry dates
- Enumerated
- 2017-07-27
- Last updated
- 2017-07-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.