Basic Information
| Provider Information | |||||||||
| NPI: | 1881717809 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POLCARI | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 143 LONGWATER DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 143 LONGWATER DRIVE | ||||||||
| Address2: | |||||||||
| City: | NORWELL | ||||||||
| State: | MA | ||||||||
| PostalCode: | 02061 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7818785200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 01/08/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 231128 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | J41942 | 01 | MA | BCBS | OTHER | 7884673 | 01 | CIGNA | OTHER | 042297845 | 01 | GIC - UNICARE | OTHER | 1881717809 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | AA95814 | 01 | HARVARD PILGRIM | OTHER | 042297845 | 01 | MA | TRICARE | OTHER | 110090797 | 05 | MA | MEDICAID | 479238 | 01 | TUFTS AND TMP | OTHER | 042297845 | 01 | PHCS - MULTI-PLAN | OTHER | 1881717809 | 01 | FALLON | OTHER | 95831902 | 01 | NETWORK HEALTH | OTHER | 9755082 | 01 | AETNA | OTHER |