Individual provider · Type 1 NPI

Liora Polvanov

Specialist · Melville, NY

NPI number 1265948020 Active

Practice location

225 Broadhollow Rd
Melville, NY 11747-4822

Call (631) 385-7780 Map

Fax (631) 385-7795

Mailing address

7000 Austin St
Forest Hills, NY 11375-1022

Specialties and licenses

TaxonomyCodeLicense
Behavior Technician 106S00000XNone listed
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1265948020

Liora Polvanov's National Provider Identifier is 1265948020, issued on Dec 15, 2017. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Melville, NY. The record was last updated on Mar 1, 2019.