Provider Demographics
NPI:1801697552
Name:SCHRADER POLCZER, GYORGY (LAC)
Entity type:Individual
Prefix:
First Name:GYORGY
Middle Name:
Last Name:SCHRADER POLCZER
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6358 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2526
Mailing Address - Country:US
Mailing Address - Phone:919-619-8689
Mailing Address - Fax:
Practice Address - Street 1:6358 WOODBINE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-2526
Practice Address - Country:US
Practice Address - Phone:919-619-8689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAC-1095171100000X
PAAK001418171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist