Provider Demographics
NPI:1972789659
Name:POLONI AND ASSOCIATES
Entity Type:Organization
Organization Name:POLONI AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:POLONI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-741-4071
Mailing Address - Street 1:8 WYNTRE BROOKE DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4535
Mailing Address - Country:US
Mailing Address - Phone:717-741-4071
Mailing Address - Fax:717-741-6660
Practice Address - Street 1:8 WYNTRE BROOKE DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4535
Practice Address - Country:US
Practice Address - Phone:717-741-4071
Practice Address - Fax:717-741-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-13
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS5053-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty