Polly Sacco Ezzell, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

RN328351L Issued in PA

Practice address

1601 Cherry St Ste 11484
Phila, PA 19102-1312

Phone

(215) 255-7304

NPI assigned

Sep 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1902457609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WATERVILLE RD",
            "city": "WALLINGFORD",
            "state": "PA",
            "postal_code": "190867001",
            "telephone_number": "610-876-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CHERRY ST STE 11484",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191021312",
            "telephone_number": "215-255-7304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCO EZZELL",
        "first_name": "POLLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "PA",
            "license": "RN328351L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ps867@drexel.edu",
            "affiliation": "N",
            "address_1": "1601 Cherry St Ste 11484",
            "city": "Phila",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191021312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Lee Rush, DDS
• Jessica Dean Russo, PSY.D.
• Eileen Ryan, CRNP
• Tierra Toni Ryan, PHARM.D
• S.G. Isaacs Enterprises, Inc.
• Duri Sabina Saeed
• Mariam Salahou, CRNP
• Salana, Inc.
• Stacey Saleff, MOTR/L, RYT
• John Avery Salvia, PA

• Community Health Registered Nurse in Phila, PA
• Providers in Phila, PA by specialty
• Community Health Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.