Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 243927 | NY |
Y | 207RI0011X | Interventional Cardiology | 243927 | NY |
NPI | 1023206505 |
---|---|
Provider Name | Dr. Sotir Polena |
First Address | Huntington, NY 11743-2948 |
Second Address | Huntington, NY 11743-2948 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 19/03/2020 |