Individual
MICHAEL J POLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
15 2ND AVE FL 3, BROOKLYN, NY 11215-2711
(718) 514-6007
Mailing address
30 E 95TH ST, NEW YORK, NY 10128-0718
(914) 584-8182
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
712808
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405258
NY
Other
Enumeration date
06/20/2023
Last updated
12/18/2023
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