DR. LARISSA POLANCO (NPI# 1811103898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811103898 |
| Entity Type | Individual |
| Full Name | DR. LARISSA POLANCO |
| Credential | MD |
| Practice Address |
80th St & 41st Ave Elmhurst NY 11373-1329 |
| Mailing Address |
79-01 Broadway Managed Care, D1-01 Elmhurst NY 11373-1329 |
| Practice Telephone | 7183343150 |
| Practice Fax Number | 7183345958 |
| Mailing Telephone | 7183341921 |
| Mailing Fax Number | 7183343432 |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 243513 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00246075 | 05 |
| Street Address |
80TH ST & 41ST AVE |
| City | ELMHURST |
| State | NY |
| Zip Code | 11373-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841395597 | Nima Akhavan | Psychiatry & Neurology | 80th St & 41st Ave, Elmhurst, NY 11373-1329 | 2006-09-14 |
| 1124203898 | Aaron Michael Lipskar | Hospitalist | 80th St & 41st Ave, Elmhurst, NY 11373-1132 | 2007-12-31 |
| 1861677536 | Karisma Sita Ajodah | Social Worker | 80th St & 41st Ave, Elmhurst, NY 11373-1329 | 2007-12-31 |
| 1669657334 | Simon D Marshall | Counselor | 80th St & 41st Ave, Elmhurst, NY 11373-1329 | 2007-12-31 |
| 1366637886 | Monica Jean Bilboul | Clinical Neuropsychologist | 80th St & 41st Ave, Elmhurst, NY 11373-1329 | 2007-09-07 |
| 1336355403 | Samuel Sebastianne Sostre | Psychiatry & Neurology | 80th St & 41st Ave, Elmhurst, NY 11373-1329 | 2007-05-15 |
| 1578685335 | Ann Marie Theresa Sullivan | Psychiatry & Neurology | 80th St & 41st Ave, Elmhurst, NY 11373 | 2007-04-04 |
| 1003937277 | Carlota Gabriel Antonio | Nurse Practitioner | 80th St & 41st Ave, Elmhurst, NY 11373 | 2007-04-03 |
| 1598887523 | Bonnie Pepper | Psychologist | 80th St & 41st Ave, Elmhurst, NY 11373 | 2007-04-03 |
| 1487776423 | Lyudmila Sorkin | Nurse Practitioner | 80th St & 41st Ave, Elmhurst, NY 11373 | 2007-04-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152736 | Carlos Eduardo Hallo Carrasco | Student in an Organized Health Care Education/Training Program | 79-01 Broadway, 10, C 10-19a, Elmhurst, NY 11373 | 2020-07-30 |
| 1912524034 | Jurian Feygen Kaunang | Student in an Organized Health Care Education/Training Program | Bronx-lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 11373 | 2020-07-06 |
| 1407471352 | Shreeya Parajull | Student in an Organized Health Care Education/Training Program | 79-01 Broadway Elmhurst Hospital Center:, Room A7-34, Elmhurst, NY 11373 | 2020-06-16 |
| 1114542479 | Mahmud Omar Elfituri | Student in an Organized Health Care Education/Training Program | 79-01 Boradway, Elmhurst, NY 11373 | 2020-06-12 |
| 1568091452 | Nudjarin Unsin | Licensed Practical Nurse | 7517 41stave, Apt.f3, Elmhurst, NY 11373 | 2020-04-03 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1821647926 | Shahorin Monzoor | Student in an Organized Health Care Education/Training Program | 81 14 Queens Boulavard, 1st Floor, Elmhurst, NY 11373 | 2019-09-11 |
| 1174184600 | Zoila Josefina Cano Rodriguez | Student in an Organized Health Care Education/Training Program | 7802 41st Ave, Elmhurst, NY 11373 | 2019-06-25 |
| 1891355756 | Kanghee Cho | Registered Nurse | 4143 77th St Elmhurst, Elmhurst, NY 11373 | 2019-06-13 |
| 1861971947 | Allen G Luke | Acupuncturist | 86-21 53 Ave, Elmhurst, NY 11373 | 2018-08-09 |
| Find all providers in zip 11373 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508332602 | Citywide Pediatrics Pllc | Pediatrics | 4033 76th St Ste 1, Elmhurst, NY 11373-1036 | 2018-10-17 |
| 1174065338 | Dev R. Master, Md, Pllc | Pediatrics | 8823 Justice Ave, Elmhurst, NY 11373-4558 | 2016-11-04 |
| 1164802419 | Jennifer Mathew | Pediatrics | 152 N Addison Ave Ste 200, Elmhurst, IL 60126-2821 | 2015-06-02 |
| 1093108607 | Dev Rashmin Master | Pediatrics | 88-23 Justice Ave., Elmhurst, NY 11373 | 2015-03-07 |
| 1992046577 | Immaculada Santiago Espiritu | Pediatrics | 83-21 Dongan Avenue Apt 1b, Elmhurst, NY 11373 | 2013-03-07 |
| 1154690865 | Xeres Yasmin Villanueva Sanchez | Pediatrics | 4015 Hampton St, Apt 3h, Elmhurst, NY 11373-2062 | 2011-12-26 |
| 1619124823 | Melissa Renee Ricafrente Grageda | Pediatrics | 7402 43rd Ave Apt 3j, Elmhurst, NY 11373-1840 | 2008-08-20 |
| 1083815385 | Advanced Pediatrics, PC | Pediatrics | 9436 59th Ave, Suite C4, Elmhurst, NY 11373-5151 | 2007-05-31 |
| 1679787378 | Elaine Itzu Chen | Pediatrics | 94-25 43rd Avenue, Elmhurst, NY 11373-2853 | 2007-05-10 |
| 1538203690 | Muhammad J.s.khan Md,pc | Pediatrics | 4018case Street, Main Floor, Elmhurst, NY 11373 | 2007-02-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.