Individual
MARY LAKE POLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16 E 60TH ST, NEW YORK, NY 10022-1002
(212) 326-5765
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-4098
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
238536-1
NY
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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