Provider Demographics
NPI:1932497120
Name:POLETICK, EILEEN BLECHMAN (RN, DNP)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:BLECHMAN
Last Name:POLETICK
Suffix:
Gender:F
Credentials:RN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 EDGEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9313
Mailing Address - Country:US
Mailing Address - Phone:973-584-3522
Mailing Address - Fax:
Practice Address - Street 1:8 EDGEWOOD PL
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9313
Practice Address - Country:US
Practice Address - Phone:973-584-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNR53875163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse