Individual
EVAN POLAKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
29 E MOUNTAIN ST, WORCESTER, MA 01606-1400
(508) 853-0556
(508) 853-1308
Mailing address
24 BOURNE ST APT B, WORCESTER, MA 01606-2393
(978) 965-1827
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
06/11/2019
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