Individual
TERRY J POLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
61 FRONTAGE RD, HAMPTON, NJ 08827-4001
(908) 735-2594
Mailing address
61 FRONTAGE RD, HAMPTON, NJ 08827-4001
(908) 735-2594
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA06995200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8748501
—
NJ
Enumeration date
02/15/2006
Last updated
07/08/2007
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