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General NPI Number Information
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NPI Number | 1255322491
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Entity Type | Individual
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Provider Name | MARIAN POLIUS-MCLEAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 08/23/2023
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Provider Practice Location Address
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Address Line | 120 MADISON AVE SUITE D
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City | MOUNT HOLLY
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State | NJ
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Zip | 08060-2055
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Country | US
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Telephone | 609-261-1660
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Fax | 609-261-1779
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Provider Business Mailing Address
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Address Line | 107 NORTHAMPTON DR
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City | WILLINGBORO
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State | NJ
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Zip | 08046-1355
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Country | US
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Telephone | 609-871-9584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN540977
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | MA107717
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | L6-0A00555
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License Number State | DE
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