Individual
BENNY POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
2299 LORING PL N, # 3, BRONX, NY 10468-5800
(646) 483-9359
Mailing address
2299 LORING PL N, # 3, BRONX, NY 10468-5800
(646) 483-9359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
476589
NY
Other
Enumeration date
01/16/2012
Last updated
01/16/2012
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