Polvanov, Liora

Polvanov, Liora is an individual health care provider with primary practice located at 225 Broadhollow Rd , Melville NY 11747-4822. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Polvanov, Liora can be contacted via phone (631) 385-7780.

Contact Information

Primary practice address
225 Broadhollow Rd Melville NY 11747-4822
Phone: (631) 385-7780
Fax: (631) 385-7795
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1265948020
LBN Legal business name Polvanov, Liora
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2017
Last updated Mar 1st, 2019 - about 7 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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