GUSTAVO EMIL POLANCO HERNANDEZ

BRONX, NY
NPI1013558188
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  029357)
Additional Taxonomies207RC0200X Internal Medicine, Critical Care Medicine
(Licence: FL  PA9112633)
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: FL  PA9112633)
363A00000X Physician Assistant
(Licence: FL  PA9112633)
207T00000X Neurological Surgery
(Licence: FL  Pa9112633)
363AS0400X Physician Assistant, Surgical
(Licence: FL  PA9112633)
Enumeration Date2019-09-30
Last Update Date2023-01-12
Business Address
GUSTAVO EMIL POLANCO HERNANDEZ PA
2015 GRAND CONCOURSE
BRONX, NY 10453-4303
Phone number: 718-583-7736
Mailing Address
GUSTAVO EMIL POLANCO HERNANDEZ PA
2626 HALPERIN AVE
BRONX, NY 10461-2631
Phone number: 718-618-0401