Basic Information
| Provider Information | |||||||||
| NPI: | 1477646941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POLISHCHUK | ||||||||
| FirstName: | YELENA | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | BERGEN REGIONAL MEDICAL CENTER | ||||||||
| Address2: | PO BOX 667 | ||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076530667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019674000 | ||||||||
| FaxNumber: | 2019674205 | ||||||||
| Practice Location | |||||||||
| Address1: | BERGEN REGIONAL MEDICAL CENTER | ||||||||
| Address2: | 230 E RIDGEWOOD AVE | ||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019674000 | ||||||||
| FaxNumber: | 2019674205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 26NJ00057200 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.