Individual provider Active NPI

Tatsiana Polonskiy

  • Specialist
  • Staten Island, NY
National Provider Identifier
1982966339
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
2388303 Issued in NY
Practice address
1835 Richmond Rd
Staten Island, NY 10306-2560
Phone
(917) 407-8052
Fax
(718) 701-1188
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2388303 NY Primary

Addresses

Primary practice location

1835 Richmond Rd
Staten Island, NY 10306-2560

Mailing address

1835 Richmond Rd
Staten Island, NY 10306-2560
Phone (917) 407-8052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2388303NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1982966339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062560",
            "telephone_number": "917-407-8052",
            "fax_number": "718-701-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062560",
            "telephone_number": "917-407-8052",
            "fax_number": "718-701-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONSKIY",
        "first_name": "TATSIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "2388303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.