Healthcare Provider Details

I. General information

NPI: 1982927687
Provider Name (Legal Business Name): LINDSAY POLVINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 PARK AVE
DUNKIRK NY
14048-2506
US

IV. Provider business mailing address

727 PARK AVE
DUNKIRK NY
14048-2506
US

V. Phone/Fax

Practice location:
  • Phone: 716-785-1982
  • Fax:
Mailing address:
  • Phone: 716-785-1982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN00312
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number299937
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: