Polykoff, Gary I

Polykoff, Gary I is an sole proprietor health care provider with primary practice located at 15 Parkman St Wac 340 Anesthesia Pain Management, Boston MA 02114-3117. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Polykoff, Gary I can be contacted via phone (617) 726-3512.

Contact Information

Primary practice address
15 Parkman St Wac 340 Anesthesia Pain Management Boston MA 02114-3117
Phone: (617) 726-3512
Fax: (617) 726-3519
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 81894 Massachusetts
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 81894 Massachusetts

Profile Details

NPI number 1063402352
LBN Legal business name Polykoff, Gary I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2005
Last updated Sep 22nd, 2011 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063402352 NPPES
Massachusetts MEDICAID 3186733
Massachusetts Other J19417
Massachusetts Other 081894

Popular Providers