Provider Demographics
NPI:1124514146
Name:POLCARI, ANN (PHD, APRN, PCNS)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:POLCARI
Suffix:
Gender:F
Credentials:PHD, APRN, PCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SERVICE 152 MAILSTOP 327
Mailing Address - Street 2:115 MILL ST.
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478
Mailing Address - Country:US
Mailing Address - Phone:617-957-1503
Mailing Address - Fax:
Practice Address - Street 1:SERVICE BUILDING MC LEAN HOSPITAL
Practice Address - Street 2:115 MILL STREET
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478
Practice Address - Country:US
Practice Address - Phone:617-957-1503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN164807364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health