Individual
MRS. SIOBHAN MARIE POLESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2342
Mailing address
111 E 210TH ST, ROSENTHAL 4, BRONX, NY 10467-2401
(718) 741-2487
(718) 920-4351
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
381531
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F381531
LICENSE
NY
Enumeration date
10/31/2007
Last updated
05/14/2019
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