National Provider Identifier

Eric A Polise

Eric A Polise is listed in the NPPES registry with a primary specialty of Dentist in Geneva, NY and a listed phone number of (315) 781-2002.

NPI 1780707869Geneva, NYDentist

Profile Overview

NPI
1780707869
Provider Type
Individual
Primary Specialty
Dentist
Enumeration Date
April 06, 2007
Last Updated
July 08, 2007

Practice Location

  • 30 Elm Street
  • Geneva, NY 14456

Phone: (315) 781-2002

Specialties

  • Dentist (122300000X)
Full Record
NPI
1780707869
Entity Type
Individual
Last Name
Polise
First Name
Eric
Middle Name
A
Mailing Street Address
30 Elm Street
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456
Mailing Country
US
Mailing Phone
(315) 781-2002
Mailing Fax
(315) 781-2422
Practice Street Address
30 Elm Street
Practice City
Geneva
Practice State
NY
Practice ZIP Code
14456
Practice Country
US
Practice Phone
(315) 781-2002
Practice Fax
(315) 781-2422
Enumeration Date
April 06, 2007
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Dentist (122300000X)
Other Identifiers
02571011 (NY)