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General NPI Number Information
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NPI Number | 1508416470
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Entity Type | Individual
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Provider Name | MISS ANASTASIA MARIE POLAR
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Gender | Female
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 755 NEW YORK AVE STE 230
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City | HUNTINGTON
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State | NY
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Zip | 11743-4285
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Country | US
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Telephone | 516-207-9782
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Fax | 516-788-8368
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Provider Business Mailing Address
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Address Line | 338 JERICHO TPKE STE 156
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City | SYOSSET
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State | NY
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Zip | 11791-4507
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Country | US
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Telephone | 516-207-9782
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Fax | 516-788-8368
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 013014-01
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License Number State | NY
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