Basic Information
| Provider Information | |||||||||
| NPI: | 1821206293 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLCARI | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GRIFFIN | ||||||||
| OtherFirstName: | CHRISTINE | ||||||||
| OtherMiddleName: | D. | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 75 WASHINGTON STREET | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020619147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 WASHINGTON STREET | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020619147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | 7818786750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 04/19/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 231131 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 7306197 | 01 | CIGNA | OTHER | AA94289 | 01 | MA | HARVARD PILGRIM | OTHER | 042297845 | 01 | TRICARE | OTHER | 2142341 | 05 | MA | MEDICAID | 458990 | 01 | MA | TUFTS | OTHER | 129320 | 01 | MA | FALLON | OTHER | 458990 | 01 | MA | TUFTS MEDICARE PREFERRED | OTHER | 7104170 | 01 | MA | AETNA | OTHER | J42039 | 01 | MA | BCBS | OTHER | 042297845 | 01 | MA | UHC | OTHER | 7104170 | 01 | AETNA | OTHER | AA94289 | 01 | MA | H.P. | OTHER | 0042151 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 042297845 | 01 | MA | GWHC | OTHER | J42039 | 01 | MA | BCBS MA | OTHER | 042297845 | 01 | MA | UNITED HEALTH CARE | OTHER |