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Organization
MICHAEL POLISENO FAMILY HEALTH NURSE PRACTITIONER PC
Active
Organization
MICHAEL POLISENO FAMILY HEALTH NURSE PRACTITIONER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL POLISENO FNP (PRESIDENT)
(516) 375-5904
Entity
Organization
Contact information
Practice address
2094 MERRICK AVE, MERRICK, NY 11566-3147
(516) 375-5904
(516) 804-2784
Mailing address
2094 MERRICK AVE, MERRICK, NY 11566-3147
(516) 375-5904
(516) 804-2784
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F333205
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100021981
MEDICARE PTAN
NY
Enumeration date
09/29/2009
Last updated
08/19/2015
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