Most Relevant Information
Provider Data
| NPI Number: | 1003536350 |
| Provider Name: | POLINA NISANOVA |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/29/2022 |
| Last Updated: | 08/29/2022 |
Provider Practice Location
385 OCEAN PKWY FL 2
BROOKLYN
NY
112184754
Practice Location Phone/Fax
| Phone: | 6465003448 |
| Fax: |
Provider Mailing Location
385 OCEAN PKWY FL 2
BROOKLYN
NY
112184754
Provider Mailing Phone/Fax
| Phone: | 6465003448 |
| Fax: |