Polonchek, Jeanna Suzanne
Polonchek, Jeanna Suzanne is an sole proprietor health care provider with primary practice located at 1 Recovery Rd Suite Four, Wareham MA 02571-5011. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Polonchek, Jeanna Suzanne can be contacted via phone (508) 295-8800.Contact Information
Primary practice address
1 Recovery Rd Suite Four
Wareham MA 02571-5011
Phone: (508) 295-8800
Fax: (508) 295-9467
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 248 | Massachusetts |
Profile Details
| NPI number | 1790745693 |
|---|---|
| LBN Legal business name | Polonchek, Jeanna Suzanne |
| Credentials | ED.D, ATC, CPED, OT- |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Sep 8th, 2009 - about 17 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 | 1790745693 | NPPES |
| Massachusetts | Other | 5788400001 | PTAN |
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