IT Consulting and Managed Services

Practical IT for businesses that need it to just work.

Lakewood Tech · Founder

I run an IT shop for small and mid-sized businesses. Helpdesk, Microsoft 365, networking, security, backup, and cloud. Twenty plus years in the field, much of it in healthcare and high-uptime environments. If your tech is slowing you down, I can help.

HIPAA experience Multi-site networks Bradenton, FL and remote
Richard Palazzo

The person behind the work.

I've spent more than two decades running IT for healthcare groups, MSPs, and businesses that can't afford downtime.

Today I'm IT Director for a 9-location, 300-user surgical group across the Tri-State area, and founder of Lakewood Tech, my managed services and consulting practice. Before that, I ran PalazzoTech as a full MSP from 2014 to 2021 and led the help desk supporting roughly 50,000 users at North Shore-LIJ Health System through Allscripts.

I work hands on. I write the migration plan, I configure the firewall, I sit on the call when something breaks at 7am. I keep things small on purpose so clients talk to the person who's actually doing the work.

20+
Years in IT
9
Locations I run today
300
Users supported daily
50K
Health system users led

What I do, and what you get out of it.

Everything below is something I've done as a day job, not a slide on a brochure. Pick what you need or hand me the whole stack.

01

Helpdesk and end-user support

Ticketing, SLAs, escalation, and on-call coverage for the people in your office who just want their printer to work. I've run multi-site help desks for years, including a hospital environment.

Outcome: your team stops waiting on tech and gets back to work.
02

Networking

Firewalls, VLANs, wireless, multi-site routing, and VPN. I've designed and run networks across 9 office locations with reliable inter-site traffic and clean segmentation.

Outcome: a network you don't have to think about.
03

Microsoft 365 and Entra ID

Tenant setup, mailbox migration, SharePoint and OneDrive, Teams, conditional access, and identity hygiene. Done right the first time, with licensing that matches what you actually use.

Outcome: email, files, and identity that hold up to an audit.
04

Security: MFA, EDR, and the basics done well

Multifactor across every account that matters, endpoint protection on every machine, patch discipline, email filtering, and access controls. Most breaches I've cleaned up came from missing fundamentals, not exotic attacks.

Outcome: ransomware and credential theft stop being likely.
05

Backup and disaster recovery

Image-based backups, off-site replication, tested restores, and a written runbook for the day something fails. I built the BC/DR program for my healthcare client from scratch.

Outcome: a bad day stays a bad day, not a closed business.
06

Cloud (Azure and AWS)

Lift-and-shift, hybrid setups, M365 and Azure tenant work, identity federation, and cost cleanup on cloud bills that have drifted. Migrated a 9-location healthcare group from on-prem to cloud and virtual platforms.

Outcome: predictable bills and remote access that holds up.
07

Automation and scripting

PowerShell for the repetitive stuff, RMM automation, and AI tools plugged into clinical and admin workflows where they actually save time. I'm picky about where automation helps and where it just adds risk.

Outcome: fewer hours spent on tasks a script can run.
08

Virtual CTO and IT strategy

For owners and execs who need a technology adult in the room without hiring a six-figure VP. Roadmaps, budgets, vendor reviews, and quarterly check-ins to keep IT pointed at what the business needs.

Outcome: tech spending you can defend, on a plan you can read.

A few projects, anonymized.

Real engagements, real numbers, no client names. Happy to talk specifics under NDA.

Multi-location healthcare group, on-prem to cloud

9 locations · 300 users · 30 providers
Situation
A surgical group running on aging on-prem servers across nine offices in a HIPAA-regulated environment. Remote access was patchy, hardware was end-of-life, and recovery from a site outage would have taken days.
What I did
Migrated the file, identity, and productivity stack to Microsoft 365 and Azure. Stood up VPN and conditional access for remote work. Rebuilt the help desk into a single ticketing system with SLAs across all nine sites. Designed a VoIP system to replace the legacy phones tying offices together.
Result
Remote access stopped being a daily complaint. Hardware refresh and maintenance costs dropped. Ticket resolution stabilized across sites instead of varying by office. The group still runs on the design I put in.

HIPAA-grade backup and disaster recovery program

Multi-specialty practice · Healthcare
Situation
Patient data was being backed up to a mix of local drives and a backup tool nobody had tested in over a year. A failed restore would have been a HIPAA reportable event.
What I did
Designed a layered BC/DR program: image-based backups, off-site replication, retention tuned to compliance requirements, and a written recovery runbook. Ran restore tests against real workloads and trained staff on the recovery procedure.
Result
A recovery target measured in hours instead of days. Backups verified on a schedule rather than on faith. Risk posture documented for compliance review.

MSP build and exit

PalazzoTech Inc. · 2014 to 2021
Situation
Started a full-service IT MSP from zero, serving small and mid-sized business clients on Long Island. Needed to deliver enterprise-grade tooling at a price small businesses could pay.
What I did
Built recurring-revenue managed contracts with defined SLAs. Stood up 24/7 monitoring, patch management, and remote support on an RMM and PSA stack. Delivered M365 and Azure migrations, network and server engineering, virtualization, backup, and a layered security program across the book of business.
Result
Grew and ran the practice for seven years. When I relocated to Florida in 2021, I transitioned the client base and ongoing operations to a partner MSP without an interruption in service.

Enterprise help desk leadership at scale

Allscripts at North Shore-LIJ · ~50,000 users
Situation
Hospital system help desk handling high call volume, VIP escalations, and clinical applications that couldn't go down during patient hours.
What I did
Led a team of analysts. Owned call volume, SLA adherence, and escalation paths for high-priority and VIP incidents. Covered on-call and on-site support across hospital locations for network, hardware, and clinical app issues.
Result
Kept clinical staff working through outages and after-hours incidents. Gave me a playbook for running help desks I've used ever since.

Tools I actually use.

Only what I've run in production. If something isn't here, I'll tell you before I quote it.

Technology and platforms

Cloud and identity
Microsoft 365 Azure Entra ID Active Directory Windows Server Virtualization
Networking
Cisco SonicWall Dell
Security and endpoint
Sophos Webroot Citrix
Backup and continuity
Veritas Backup Exec
RMM, PSA, and comms
Kaseya ConnectWise RingCentral VoIP AI and automation tooling

Certifications and training

  • HDI Support Center Analyst, Certified
  • CompTIA Network+ (N10-003), Certified
  • CompTIA A+ (Essentials and IT Technician), Certified
  • ConnectWise, Certified
  • HIPAA Awareness Training

Unitek IT Technical College, Information Technology

SUNY Farmingdale, AutoCAD Training

References

Client and employer references are available on request. I'll connect you with the people who can speak to the work directly.

Tell me what's going wrong.

Email, call, or drop a note below. I read every message myself and usually respond within a business day.