Provider Demographics
NPI:1740247303
Name:POLERA, CATHERINE B (DO)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:B
Last Name:POLERA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:NY
Mailing Address - Zip Code:10516-1403
Mailing Address - Country:US
Mailing Address - Phone:845-337-5455
Mailing Address - Fax:
Practice Address - Street 1:225 WILLIAMSON ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3625
Practice Address - Country:US
Practice Address - Phone:908-994-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206322207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01915939Medicaid
NY29C961Medicare ID - Type Unspecified
NYH06602Medicare UPIN