Provider Demographics
NPI:1902055486
Name:POLINSKI, DONNA
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:POLINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9858 TOBERMORY AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-2508
Mailing Address - Country:US
Mailing Address - Phone:716-759-1128
Mailing Address - Fax:
Practice Address - Street 1:9858 TOBERMORY AVE
Practice Address - Street 2:
Practice Address - City:CLARENCE
Practice Address - State:NY
Practice Address - Zip Code:14031-2508
Practice Address - Country:US
Practice Address - Phone:716-759-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104526-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse