National Provider Identifier
Mary Therese Polvino
Mary Therese Polvino is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Jamestown, NY and a listed phone number of (716) 338-0668.
Profile Overview
- NPI
- 1992463764
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- November 29, 2021
- Last Updated
- October 11, 2023
Practice Location
- 774 Fairmount Ave
- Jamestown, NY 14701-2609
Phone: (716) 338-0668
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1992463764
- Entity Type
- Individual
- Last Name
- Polvino
- First Name
- Mary
- Middle Name
- Therese
- Mailing Street Address
- 774 Fairmount Ave
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-2609
- Mailing Country
- US
- Mailing Phone
- (716) 338-0668
- Practice Street Address
- 774 Fairmount Ave
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-2609
- Practice Country
- US
- Practice Phone
- (716) 338-0668
- Enumeration Date
- November 29, 2021
- Last Updated
- October 11, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 11, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)