Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT028233 | PA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT028233 | PA |
NPI | 1003452855 |
---|---|
Provider Name | Arianne Polatnick |
First Address | Huntingdon Valley, PA 19006-2706 |
Second Address | Feasterville Trevose, PA 19053-7680 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2019 |
Last Update Date | 26/11/2019 |