Provider Demographics
NPI:1962849661
Name:POLSKY, MIRIAM L
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:L
Last Name:POLSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MIRIAM
Other - Middle Name:L
Other - Last Name:SCHULTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14452 72ND RD
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2406
Mailing Address - Country:US
Mailing Address - Phone:773-742-0592
Mailing Address - Fax:
Practice Address - Street 1:135 W 50TH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-1201
Practice Address - Country:US
Practice Address - Phone:212-582-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program