Most Relevant Information
Provider Data
| NPI Number: | 1003307554 |
| Provider Name: | MIRANDA POLASKI PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 4140 |
Most Important Dates
| Enumeration Date: | 05/21/2018 |
| Last Updated: | 08/22/2018 |
Provider Practice Location
81 MERIDEN AVE
SOUTHINGTON
CT
06489
Practice Location Phone/Fax
| Phone: | 8602765000 |
| Fax: |
Provider Mailing Location
81 MERIDEN AVE
SOUTHINGTON
CT
064893268
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |