Individual
MIRANDA POLASKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
81 MERIDEN AVE, SOUTHINGTON, CT 06489
(860) 276-5000
Mailing address
81 MERIDEN AVE, SOUTHINGTON, CT 06489-3268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4140
CT
Other
Enumeration date
05/21/2018
Last updated
08/22/2018
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