Individual
POLINA M MELAMUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9 CRANBROOK BLVD FL 2, ENFIELD, CT 06082-3889
(860) 962-6600
Mailing address
30 JORDAN LN, WETHERSFIELD, CT 06109-1278
(860) 263-0253
(860) 263-0262
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
004699
CT
363LA2200X
Adult Health Nurse Practitioner
Primary
004699
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004699
LICENSE
CT
Enumeration date
07/26/2011
Last updated
06/25/2021
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