Active NPI
Tatianna Polonsky, MD
- Psychiatry Physician
- Brooklyn, NY
National Provider Identifier
1174639322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 211421
- Practice address
- 760 Broadway
5A-123
Brooklyn, NY 11206-5317 - Phone
- (718) 963-8419
- Fax
- (718) 630-3138
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 211421 | NY | Primary |
Addresses
Primary practice location
760 Broadway
5A-123
Brooklyn, NY 11206-5317
Mailing address
760 Broadway
5A-123
Brooklyn, NY 11206-5317
Phone (718) 963-8419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174639322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"address_2": "5A-123",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065317",
"telephone_number": "718-963-8419",
"fax_number": "718-630-3138"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 BROADWAY",
"address_2": "5A-123",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112065317",
"telephone_number": "718-963-8419",
"fax_number": "718-630-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLONSKY",
"first_name": "TATIANNA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "211421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.