Individual
SAMUEL ANTONIO RODRIGUEZ POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
8824 242ND ST, BELLEROSE, NY 11426-1241
(781) 346-7191
Mailing address
8824 242ND ST, BELLEROSE, NY 11426-1241
(781) 346-7191
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
18-152
NY
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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