Individual
ALEVTINA POLIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6295 SAUNDERS ST, 6P, REGO PARK, NY 11374-1567
(718) 896-1061
Mailing address
6295 SAUNDERS ST, 6P, REGO PARK, NY 11374-1567
(718) 896-1061
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1141248
NY
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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