Polivy, Kenneth D
Polivy, Kenneth D is an individual health care provider with primary practice located at 2000 Washington St Suite 341, Newton MA 02462-1650. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Polivy, Kenneth D can be contacted via phone (617) 964-0024.Contact Information
Primary practice address
2000 Washington St Suite 341
Newton MA 02462-1650
Phone: (617) 964-0024
Fax: (617) 964-6374
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 47345 | Massachusetts |
Profile Details
| NPI number | 1194794115 |
|---|---|
| LBN Legal business name | Polivy, Kenneth D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Nov 1st, 2011 - about 14 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 | 1194794115 | NPPES |
| Massachusetts | MEDICAID | 6183484 | |
| Massachusetts | Other | 17266 | |
| Massachusetts | Other | 047345 | |
| Massachusetts | Other | J03453 |
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