Polykoff, Gary I
Polykoff, Gary I is an sole proprietor health care provider with primary practice located at 15 Parkman St Wac 340 Anesthesia Pain Management, Boston MA 02114-3117. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Polykoff, Gary I can be contacted via phone (617) 726-3512.Contact Information
Primary practice address
15 Parkman St Wac 340 Anesthesia Pain Management
Boston MA 02114-3117
Phone: (617) 726-3512
Fax: (617) 726-3519
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 81894 | Massachusetts |
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 81894 | Massachusetts |
Profile Details
| NPI number | 1063402352 |
|---|---|
| LBN Legal business name | Polykoff, Gary I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 27th, 2005 |
| Last updated | Sep 22nd, 2011 - about 15 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 | 1063402352 | NPPES |
| Massachusetts | MEDICAID | 3186733 | |
| Massachusetts | Other | J19417 | |
| Massachusetts | Other | 081894 |
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