Active NPI
Dimitry Polishchuk
- Specialist
- Caldwell, NJ
National Provider Identifier
1023929783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2101733261
- Practice address
- 40 MC Nish Way
Caldwell, NJ 07006-3801 - Phone
- (917) 579-6742
- NPI assigned
- Sep 14, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2101733261 | NY | Primary |
Addresses
Primary practice location
40 MC Nish Way
Caldwell, NJ 07006-3801
Mailing address
40 MC Nish Way
Caldwell, NJ 07006-3801
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1023929783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 MC NISH WAY",
"city": "CALDWELL",
"state": "NJ",
"postal_code": "070063801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 MC NISH WAY",
"city": "CALDWELL",
"state": "NJ",
"postal_code": "070063801",
"telephone_number": "917-579-6742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLISHCHUK",
"first_name": "DIMITRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-14",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "NY",
"license": "2101733261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.