Provider Demographics
NPI:1821534116
Name:POLANSKY, SCOTT (DO)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:POLANSKY
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 ST LUKES BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5665
Mailing Address - Country:US
Mailing Address - Phone:845-261-7354
Mailing Address - Fax:
Practice Address - Street 1:2200 ST LUKES BLVD STE 100
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5665
Practice Address - Country:US
Practice Address - Phone:845-261-7354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-11
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO4865207X00000X
MS28907207XX0801X
PAOS022376207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery