NPI 1003307554

Miranda Polaski, PA

Practitioner Physician Assistant Southington, CT

Practice location

Address: 81 Meriden Ave, Southington, CT 06489
Phone: (860) 276-5000
Mailing address: 81 Meriden Ave, Southington, CT 06489-3268

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 4140 (CT)

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Registry record

NPI: 1003307554
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 May 2018
Record last updated: 22 Aug 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.