Provider Demographics
NPI:1023362993
Name:POLISHUK, MILANA (MPT)
Entity Type:Individual
Prefix:MS
First Name:MILANA
Middle Name:
Last Name:POLISHUK
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 N BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2114
Mailing Address - Country:US
Mailing Address - Phone:215-641-9401
Mailing Address - Fax:
Practice Address - Street 1:1024 N BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-2114
Practice Address - Country:US
Practice Address - Phone:215-641-9401
Practice Address - Fax:215-654-7482
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012849L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist