Individual provider · Type 1 NPI

Stella Polvanova, N.P.

Adult Health Nurse Practitioner · Far Rockaway, NY

NPI number 1013201557 Active

Practice location

529 Beach 20th St
Far Rockaway, NY 11691-3645

Fax (718) 327-3294

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X486629-1 (NY)
Adult Health Nurse Practitioner Primary 363LA2200XF305534-1 (NY)
Gerontology Nurse Practitioner 363LG0600XF340789-1 (NY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1013201557

Stella Polvanova, N.P.'s National Provider Identifier is 1013201557, issued on Jun 1, 2011. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Far Rockaway, NY. The record was last updated on Jun 1, 2011.