Provider Demographics
NPI:1316246077
Name:ALBANO, POLA AGCAOILI (NP)
Entity type:Individual
Prefix:MS
First Name:POLA
Middle Name:AGCAOILI
Last Name:ALBANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:492 1ST AVE
Mailing Address - Street 2:ACS PREPLACEMENT SERVICES- MEDICAL UNIT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-9103
Mailing Address - Country:US
Mailing Address - Phone:646-935-1537
Mailing Address - Fax:
Practice Address - Street 1:492 1ST AVE
Practice Address - Street 2:ACS PREPLACEMENT SERVICES- MEDICAL UNIT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9103
Practice Address - Country:US
Practice Address - Phone:646-935-1537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY381129363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics