Provider Demographics
NPI:1003974858
Name:POLANECZKY, ERICA B (APNC)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:B
Last Name:POLANECZKY
Suffix:
Gender:F
Credentials:APNC
Other - Prefix:
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Mailing Address - Street 1:303 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-1240
Mailing Address - Country:US
Mailing Address - Phone:609-221-9591
Mailing Address - Fax:
Practice Address - Street 1:2906 ROUTE 130
Practice Address - Street 2:SUITE 201
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-2521
Practice Address - Country:US
Practice Address - Phone:856-764-4115
Practice Address - Fax:856-764-4116
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2024-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00042500363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health