Individual
MR. VINCENT ANTHONY POLIZIO
Active
Individual
MR. VINCENT ANTHONY POLIZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00060500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0337854
—
NJ
01
—
1122046
AMERIGROUP
NJ
01
—
641329
MEDICARE PTAN
NJ
01
—
9388255
AETNA
NJ
01
—
P5573349
OXFORD
NJ
Enumeration date
05/11/2006
Last updated
08/04/2021
Update your record
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