Provider Demographics
NPI:1558623850
Name:ZAGRANICHNAYA, POLINA
Entity Type:Individual
Prefix:MRS
First Name:POLINA
Middle Name:
Last Name:ZAGRANICHNAYA
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 1:2932 W 5TH ST
Mailing Address - Street 2:APT 19C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3964
Mailing Address - Country:US
Mailing Address - Phone:718-676-1850
Mailing Address - Fax:718-676-1855
Practice Address - Street 1:2932 W 5TH ST
Practice Address - Street 2:APT 19C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3964
Practice Address - Country:US
Practice Address - Phone:718-676-1850
Practice Address - Fax:718-676-1855
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator