Medical Office of Doctor Ilona K Polak PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

245282 Issued in NY

Legal business name

MEDICAL OFFICE OF DOCTOR ILONA K POLAK PC

Practice address

34 Bay St # 103
Sag Harbor, NY 11963-3104

Phone

(631) 808-3337

Fax

(631) 808-3338

NPI assigned

Sep 23, 2011

Last updated

Jan 19, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Ilona K Polak, M.D.NPI 1346432077

Title

President

Phone

(631) 727-6284

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ilona Katarzyna Polak, M.D.

  • Family Medicine Physician
  • Sag Harbor, NY
  • NPI 1346432077
  Medicare reassignment NPD Authorized official
• Marylen Leon

  • Family Nurse Practitioner
  • East Hampton, NY
  • NPI 1053087619
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421625600000",
    "number": "1699058958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2986",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119630402",
            "telephone_number": "631-808-3337",
            "fax_number": "631-808-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 BAY ST # 103",
            "city": "SAG HARBOR",
            "state": "NY",
            "postal_code": "119633104",
            "telephone_number": "631-808-3337",
            "fax_number": "631-808-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL OFFICE OF DOCTOR ILONA K POLAK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2015-01-19",
        "status": "A",
        "authorized_official_last_name": "POLAK",
        "authorized_official_first_name": "ILONA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-727-6284",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "245282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Helene Liot, CNM
• Ian M Mannix, DPT
• Barry Marcus, RPH
• Damian A Marrese, DO
• Laurie Ann Marsden, LCSW
• Menard Acupuncture, P.C.
• Kevin Anthony Menard, LAC
• Michelle Mesa
• Katie Miller
• Katherine Mitchell, LCSW

• Family Medicine Physician in Sag Harbor, NY
• Providers in Sag Harbor, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.