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BRIAN POLIGONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6800 PITTSFORD PALMYRA RD STE 150, FAIRPORT, NY 14450-3503
(585) 364-1177
Mailing address
6800 PITTSFORD PALMYRA RD STE 150, FAIRPORT, NY 14450-3503
(585) 364-1177

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
045363
CT
207N00000X
Dermatology Physician
Primary
248958
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02990105
NY
Enumeration date
06/19/2007
Last updated
09/20/2018
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