Provider Demographics
NPI:1831231323
Name:POLIMENI, ANGEL BAUTISTA (MD)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:BAUTISTA
Last Name:POLIMENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:220 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10573-4557
Mailing Address - Country:US
Mailing Address - Phone:914-939-6696
Mailing Address - Fax:914-939-7732
Practice Address - Street 1:220 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:PORT CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573-4557
Practice Address - Country:US
Practice Address - Phone:914-939-6696
Practice Address - Fax:914-939-7732
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY171406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine