Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.134248 | OH |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 35.134248 | OH |
NPI | 1275813206 |
---|---|
Provider Name | Veronika Polishchuk |
First Address | Columbus, OH 43205-2664 |
Second Address | Columbus, OH 43205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2011 |
Last Update Date | 27/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0301004 | (05) | OH |