Provider Demographics
NPI:1851711147
Name:POLSINELLI, TAYLOR (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:
Last Name:POLSINELLI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 UPPER GLEN ST
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-2019
Mailing Address - Country:US
Mailing Address - Phone:518-793-3132
Mailing Address - Fax:
Practice Address - Street 1:724 UPPER GLEN ST
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-2019
Practice Address - Country:US
Practice Address - Phone:518-793-3132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist