Evangeline Polan

NPI 1265794648 - Specialist - 174400000X

NPI Details
NPI 1265794648
Gender Female
Enumeration Date 06/12/2012
Last Updated 06/12/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
623 NEW LOUDON RD
LATHAM NY, 12110-4031, US
Phone (518) 782-1178
Fax
Business Location
131 EDGECOMB ST
ALBANY NY, 12209-1309, US
Phone (518) 221-2583
Fax
Toxanomy
Taxonomy Code 174400000X
License State
License Number
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According to our database, Evangeline Polan NPI is 1265794648, taxonomy code is 174400000X Evangeline Polan physically located at 623 New Loudon Rd, Latham NY, 12110-4031. NPI Number Evangeline Polan has the Individual type.

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1265794648 NPI number is provided on an as is basis without warranty of any kind. 1265794648 is maintained by the National Plan & Provider Enumeration System. The contents of Evangeline Polan are for informational purposes only.