Individual
MICHAEL POULOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1236 RXR PLZ, UNIONDALE, NY 11556-1236
(516) 252-3939
Mailing address
13 GLEN ROSE CT, WEST NYACK, NY 10994-2108
(845) 480-4792
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
297658
NY
Other
Enumeration date
05/15/2015
Last updated
06/20/2022
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