Basic Information
Provider Information
NPI: 1942316435
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POLATSCH
FirstName: DANIEL
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 321 E 34TH ST
Address2: FIRST FLOOR
City: NEW YORK
State: NY
PostalCode: 100164942
CountryCode: US
TelephoneNumber: 2123400000
FaxNumber: 2123400038
Practice Location
Address1: 321 E 34TH ST
Address2: FIRST FLOOR
City: NEW YORK
State: NY
PostalCode: 100164942
CountryCode: US
TelephoneNumber: 2123400000
FaxNumber: 2123400038
Other Information
ProviderEnumerationDate: 08/21/2006
LastUpdateDate: 10/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X211880NYY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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