Provider Demographics
NPI:1669530929
Name:POLYAK, INGA A (MD)
Entity type:Individual
Prefix:
First Name:INGA
Middle Name:A
Last Name:POLYAK
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Gender:F
Credentials:MD
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Mailing Address - Street 1:4730 S FORT APACHE RD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7945
Mailing Address - Country:US
Mailing Address - Phone:702-253-9090
Mailing Address - Fax:702-253-9083
Practice Address - Street 1:4730 S FORT APACHE RD
Practice Address - Street 2:SUITE 390
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7945
Practice Address - Country:US
Practice Address - Phone:702-253-9090
Practice Address - Fax:702-253-9083
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NV116262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry