Basic Information
| Provider Information | |||||||||
| NPI: | 1386744753 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLENSKY | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MS, RD/LDN, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 52 PINE CREEK DR | ||||||||
| Address2: | |||||||||
| City: | CARLISLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170139668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176093537 | ||||||||
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| Practice Location | |||||||||
| Address1: | 757 NORLAND AVE STE 204 | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172176820 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 08/30/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | DN003369 | PA | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.