Polukhin, Maryanna

Polukhin, Maryanna is an individual health care provider with primary practice located at 18 Cedar St Grove Hill Medical Center, Newington CT 06111-2647. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Polukhin, Maryanna can be contacted via phone (860) 666-5252.

Contact Information

Primary practice address
18 Cedar St Grove Hill Medical Center Newington CT 06111-2647
Phone: (860) 666-5252
Fax: (860) 666-5153
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 034968 Connecticut

Profile Details

NPI number 1881688034
LBN Legal business name Polukhin, Maryanna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Jul 9th, 2007 - about 19 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 1881688034 NPPES
Connecticut MEDICAID 001349689
Connecticut Other 1255448155
Connecticut Other 5247130
Connecticut Other P369816
Connecticut Other 060118
Connecticut Other 110182439
Connecticut Other 349680
Connecticut MEDICAID 004215324
Connecticut Other 010034968CT04
Connecticut Other 01034968

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