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Individual

DR. ELIO POLSINELLI JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4859 MEADOWS RD STE 155, LAKE OSWEGO, OR 97035-2628
(415) 800-7763
Mailing address
4859 MEADOWS RD STE 155, LAKE OSWEGO, OR 97035-2628

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
27OA00605800
NJ
152W00000X
Optometrist
Primary
AT4542
OR
152W00000X
Optometrist
OPT 13359T
CA
152W00000X
Optometrist
TUV 007065
NY

Other

Enumeration date
10/18/2006
Last updated
03/24/2021
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