Provider Demographics
NPI:1972568517
Name:PURIZHANSKY, POLINA (MD)
Entity Type:Individual
Prefix:DR
First Name:POLINA
Middle Name:
Last Name:PURIZHANSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 SHERIDAN DR
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4836
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-630-1014
Practice Address - Fax:716-250-5910
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196374207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01494893Medicaid
NY0406335OtherIHA
NY161000580OtherNORTH AMERICAN PREFERRED
NY000523384001OtherHEALTH NOW
NY00010141901OtherUNIVERA
NY161000580OtherEMPIRE
NY00010141901OtherUNIVERA
NY0406335OtherIHA