Provider Demographics
NPI:1821201260
Name:R.S.POLINTAN,M.D.,P.C.
Entity Type:Organization
Organization Name:R.S.POLINTAN,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:S
Authorized Official - Last Name:POLINTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-765-8590
Mailing Address - Street 1:807 TURNPIKE AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-1238
Mailing Address - Country:US
Mailing Address - Phone:814-765-8590
Mailing Address - Fax:814-765-5058
Practice Address - Street 1:807 TURNPIKE AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-1238
Practice Address - Country:US
Practice Address - Phone:814-765-8590
Practice Address - Fax:814-765-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022179E207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006788840001Medicaid
PAPO105747Medicare ID - Type Unspecified
PA0006788840001Medicaid