Polvanova, Berta
Polvanova, Berta is an sole proprietor health care provider with primary practice located at 9732 63Rd Rd , Rego Park NY 11374-1639. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Polvanova, Berta can be contacted via phone (718) 539-3646.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 008685-1 | New York |
Profile Details
| NPI number | 1730424201 |
|---|---|
| LBN Legal business name | Polvanova, Berta |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 10th, 2012 |
| Last updated | Dec 10th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730424201 | NPPES |
| New York | MEDICAID | 03396027 |
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