Provider Demographics
NPI:1154592616
Name:NUDEL, POLINA (PHARM D)
Entity type:Individual
Prefix:
First Name:POLINA
Middle Name:
Last Name:NUDEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SHORE BLVD
Mailing Address - Street 2:APT 2K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4150
Mailing Address - Country:US
Mailing Address - Phone:718-743-7802
Mailing Address - Fax:646-336-8494
Practice Address - Street 1:585 HUDSON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-2115
Practice Address - Country:US
Practice Address - Phone:646-336-8491
Practice Address - Fax:646-336-8494
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist