Provider Demographics
NPI:1447482294
Name:PLOTKIN, POLINA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:POLINA
Middle Name:
Last Name:PLOTKIN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:POLINA
Other - Middle Name:
Other - Last Name:MAYZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2850 OCEAN AVE APT F3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3172
Mailing Address - Country:US
Mailing Address - Phone:347-385-2788
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:119 (PHARMACY)
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053860183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist