Provider Demographics
NPI:1659673044
Name:POLCWIARTEK, MONIKA ANNA (PA)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:ANNA
Last Name:POLCWIARTEK
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:125 1/2 CALYER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2509
Mailing Address - Country:US
Mailing Address - Phone:212-518-6841
Mailing Address - Fax:
Practice Address - Street 1:101 SAINT ANDREWS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2254
Practice Address - Country:US
Practice Address - Phone:516-674-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-17
Last Update Date:2024-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY14336363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical