Provider Demographics
NPI:1225275951
Name:POLONOWSKI, ANNA CLAUDIA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CLAUDIA
Last Name:POLONOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 LAUREL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5364
Mailing Address - Country:US
Mailing Address - Phone:907-563-6878
Mailing Address - Fax:907-770-7939
Practice Address - Street 1:4325 LAUREL ST STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5364
Practice Address - Country:US
Practice Address - Phone:907-563-6878
Practice Address - Fax:907-770-7939
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7200876-2401225100000X
AK1638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist