Basic Information
| Provider Information | |||||||||
| NPI: | 1861688251 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL POLCINO MD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 141 LITTLE EAST NECK RD | ||||||||
| Address2: | |||||||||
| City: | WEST BABYLON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117047719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6313211045 | ||||||||
| FaxNumber: | 6313211102 | ||||||||
| Practice Location | |||||||||
| Address1: | 141 LITTLE EAST NECK RD | ||||||||
| Address2: | |||||||||
| City: | WEST BABYLON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117047719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6313211045 | ||||||||
| FaxNumber: | 6313211102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2007 | ||||||||
| LastUpdateDate: | 06/21/2021 | ||||||||
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| AuthorizedOfficialLastName: | SINI | ||||||||
| AuthorizedOfficialFirstName: | CHRIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6313211045 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 136866 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.