Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | MD017431E | PA |
NPI | 1891037644 |
---|---|
Provider Name | Dr. Martin Sander Polinsky |
First Address | Philadelphia, PA 19128-1129 |
Second Address | Philadelphia, PA 19128-1129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 20/03/2013 |