Individual
KATIE POLTORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6385 LOCUST STREET EXT, LOCKPORT, NY 14094-6511
(716) 478-4780
Mailing address
6385 LOCUST STREET EXT, LOCKPORT, NY 14094-6511
(716) 478-4780
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
691700
NY
Other
Enumeration date
11/06/2019
Last updated
11/06/2019
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