MEDICARE: EMILY POLSTEIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1780417071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY POLSTEIN

Provider Business Mailing Address
First Line	:	1001 S 49TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-3475
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 S BROAD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-2941
Country	:	US
Telephone Number	:	917-887-2018
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	08/22/2024

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Directions to “ EMILY POLSTEIN ” Practice Location

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