| Medical Office Of Doctor Ilona K Polak Pc | |
|
34 Bay St # 103 Sag Harbor NY 11963-3104 | |
| (631) 808-3337 | |
| (631) 808-3338 |
| Full Name | Medical Office Of Doctor Ilona K Polak Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 34 Bay St # 103, Sag Harbor, New York |
| Authorized Official Name and Position | Ilona K Polak (PRESIDENT) |
| Authorized Official Contact | 6317276284 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Office Of Doctor Ilona K Polak Pc Po Box 2986 Sag Harbor NY 11963-0402 Ph: (631) 808-3337 | Medical Office Of Doctor Ilona K Polak Pc 34 Bay St # 103 Sag Harbor NY 11963-3104 Ph: (631) 808-3337 |
| NPI Number | 1699058958 |
|---|---|
| Provider Enumeration Date | 09/23/2011 |
| Last Update Date | 01/19/2015 |
| Medicare PECOS PAC ID | 1850558214 |
|---|---|
| Medicare Enrollment ID | O20120214000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699058958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 245282 (New York) | Primary |
| Provider Name | Ilona K Polak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346432077 PECOS PAC ID: 8123203544 Enrollment ID: I20110429000182 |
| Provider Name | Marylen Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053087619 PECOS PAC ID: 2668879669 Enrollment ID: I20210917000968 |
John Oppenheimer, M.d., Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 60 Bay St, Sag Harbor, NY 11963 Phone: 621-725-4600 |