Provider Demographics
NPI:1578531000
Name:LAJINESS-POLOSKY, DANINE T (APRN-BC, PMHNP)
Entity Type:Individual
Prefix:
First Name:DANINE
Middle Name:T
Last Name:LAJINESS-POLOSKY
Suffix:
Gender:F
Credentials:APRN-BC, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N SUMMIT ST FL 7
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-824-6350
Mailing Address - Fax:419-882-3847
Practice Address - Street 1:5800 MONROE ST BLDG G
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2211
Practice Address - Country:US
Practice Address - Phone:419-824-6350
Practice Address - Fax:419-882-3847
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN207007363LP0808X
OH07796363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2490013Medicaid
OHQ15786Medicaid
OH7971635OtherAETNA
OHY00796OtherTHE HEALTH PLAN PIN
OH730476000OtherMAGELLAN PIN
OH000000360943OtherANTHEM PIN
OHQ15786Medicaid
OH2490013Medicaid