Provider Demographics
NPI:1174111215
Name:POLIMENI, PAT EMILIE MERECIDO (FNP)
Entity type:Individual
Prefix:MRS
First Name:PAT EMILIE
Middle Name:MERECIDO
Last Name:POLIMENI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:PAT EMILIE
Other - Middle Name:DAGPIN
Other - Last Name:MERECIDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:4256 BRONX BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2673
Mailing Address - Country:US
Mailing Address - Phone:718-515-4347
Mailing Address - Fax:718-653-8641
Practice Address - Street 1:4256 BRONX BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2673
Practice Address - Country:US
Practice Address - Phone:718-515-4347
Practice Address - Fax:718-653-8641
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347076363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily