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Contact Information

JEFFREY L POLCZINSKI PSYD LLC
5555 N PORT WASHINGTON RD
SUITE 304
GLENDALE, WI53217
 Phone: 414-967-9550
 Fax: 414-967-9550
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for JEFFREY L POLCZINSKI PSYD LLC

NPI Number 1124291976
LBN Legal business name JEFFREY L POLCZINSKI PSYD LLC
Authorized official JEFFREY POLCZINSKI - (PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 04/11/2008
Last updated 10/19/2011 - About 15 years ago
Identifiers
WI License # 1641057
WI Medicaid 39131300
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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