Individual
CARMEN ALICIA POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6485 BROADWAY APT 3H, BRONX, NY 10471-2715
(917) 945-5505
Mailing address
6485 BROADWAY APT 3H, BRONX, NY 10471-2715
(917) 945-5505
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
594146
NY
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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