Provider Demographics
NPI:1790284479
Name:POLANCO, ESTHER DENIS
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:DENIS
Last Name:POLANCO
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 1:14 SYCAMORE ST APT 18
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3258
Mailing Address - Country:US
Mailing Address - Phone:240-595-9476
Mailing Address - Fax:
Practice Address - Street 1:209 ROOT RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-9832
Practice Address - Country:US
Practice Address - Phone:413-568-3942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist