Polczinski, Jeffrey Lewis

Polczinski, Jeffrey Lewis is an sole proprietor health care provider with primary practice located at 5555 N Port Washington Rd Suite 304, Glendale WI 53217. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Polczinski, Jeffrey Lewis can be contacted via phone (414) 967-9550.

Contact Information

Primary practice address
5555 N Port Washington Rd Suite 304 Glendale WI 53217
Phone: (414) 967-9550
Fax: (414) 967-9550
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1641057 Wisconsin

Profile Details

NPI number 1306878368
LBN Legal business name Polczinski, Jeffrey Lewis
Credentials PSYD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2006
Last updated Mar 14th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306878368 NPPES
Wisconsin MEDICAID 39131300
Wisconsin Other 1641057

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