Provider Demographics
NPI:1902862691
Name:POLATSCH, BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:
Last Name:POLATSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SOUTH OYSTER BAY ROAD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801
Mailing Address - Country:US
Mailing Address - Phone:516-931-4800
Mailing Address - Fax:516-931-7241
Practice Address - Street 1:400 SOUTH OYSTER BAY ROAD
Practice Address - Street 2:SUITE 204
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801
Practice Address - Country:US
Practice Address - Phone:516-931-4800
Practice Address - Fax:516-931-7241
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091685207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11817OtherVYTRA GYN
091685B73OtherHEALTHFIRST
62186305OtherMULTIPLAN
1C8118OtherHEALTH NET
529551OtherEMPIRE
0047975OtherGHI
529551OtherMDNY
6403684OtherCIGNA
91154OtherUSH
4233993OtherAETNA
553291OtherHERITAGE
AP196OtherOXFORD
106274OtherHIP
529552OtherBCBS