Individual
NICOLE POLIDORI KOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13400 E 15 MILE RD, STERLING HTS, MI 48312
(586) 939-1122
(586) 939-9328
Mailing address
13400 E 15 MILE RD, STERLING HTS, MI 48312
(586) 939-1122
(586) 939-9328
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003891
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166710001
ADMINASTAR FEDERAL
MI
01
—
410046052
MEDICARE RAILROAD
MI
Enumeration date
07/03/2006
Last updated
02/21/2013
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