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General NPI Number Information
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NPI Number | 1669355202
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Entity Type | Individual
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Provider Name | CARMEN ABIGAIL POLANCO
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Gender | Female
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Dates
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Enumeration Date | 07/30/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 500 BI COUNTY BLVD STE 450
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City | FARMINGDALE
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State | NY
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Zip | 11735-3995
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Country | US
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Telephone | 718-264-1640
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Fax |
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Provider Business Mailing Address
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Address Line | 780 GARDEN ST APT 6E
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City | BRONX
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State | NY
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Zip | 10460-1163
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Country | US
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Telephone | 929-275-9925
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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