Individual
DR. LEE ALEXANDER POLIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4201
(401) 444-5527
Mailing address
593 EDDY ST, HASBRO 122, PROVIDENCE, RI 02903-4923
(401) 444-4201
(401) 444-5527
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD15062
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD15062
LICENSE
RI
Enumeration date
04/01/2009
Last updated
08/24/2015
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