Individual
DR. LORI G POLACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1524 ATWOOD AVE, SUITE 343, JOHNSTON, RI 02919
(401) 331-0202
(401) 421-3353
Mailing address
1524 ATWOOD AVE, SUITE 343, JOHNSTON, RI 02919
(401) 331-0202
(401) 421-3353
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
RI8046
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9020105
—
RI
Enumeration date
09/02/2006
Last updated
07/08/2010
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