| Joan Polansky | |
|
5090 N 40th St Suite 190a Phoenix AZ 85018-2111 | |
| (602) 621-0468 | |
| (602) 954-5245 |
| Full Name | Joan Polansky |
|---|---|
| Speciality | Psychologist |
| Location | 5090 N 40th St, Phoenix, Arizona |
| Authorized Official Name and Position | Joan Marie Polansky (PSYCHOLOGIST) |
| Authorized Official Contact | 6026210468 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joan Polansky 5090 N 40th St Suite 190a Phoenix AZ 85018-2111 Ph: (602) 621-0468 | Joan Polansky 5090 N 40th St Suite 190a Phoenix AZ 85018-2111 Ph: (602) 621-0468 |
| NPI Number | 1225411432 |
|---|---|
| Provider Enumeration Date | 07/07/2015 |
| Last Update Date | 07/12/2015 |
| Medicare PECOS PAC ID | 2163735713 |
|---|---|
| Medicare Enrollment ID | O20150724012187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225411432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 3399 (Arizona) | Primary |
| Provider Name | Joan M Polansky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699790030 PECOS PAC ID: 4385650894 Enrollment ID: I20090209000189 |
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