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General NPI Number Information
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NPI Number | 1538963475
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Entity Type | Individual
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Provider Name | RHONDA GLORIANN MC LEISH POLSON
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Gender | Female
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2447 EASTCHESTER RD
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City | BRONX
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State | NY
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Zip | 10469-5915
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Country | US
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Telephone | 718-882-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 21946 ALECIA AVE
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City | LAURELTON
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State | NY
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Zip | 11413-2943
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Country | US
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Telephone | 347-659-4606
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1137872
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License Number State | NY
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