Healthcare Provider Details

I. General information

NPI: 1902760382
Provider Name (Legal Business Name): CARLI POLCZYNSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 DAVID CT
IRWIN PA
15642-1613
US

IV. Provider business mailing address

1044 DAVID CT
IRWIN PA
15642-1613
US

V. Phone/Fax

Practice location:
  • Phone: 724-689-1819
  • Fax: 724-834-4347
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP034367
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: