Provider Demographics
NPI:1679336283
Name:POLEN, TAJ ARNAE (CPR & AED, FIRST AID)
Entity type:Individual
Prefix:MR
First Name:TAJ
Middle Name:ARNAE
Last Name:POLEN
Suffix:
Gender:M
Credentials:CPR & AED, FIRST AID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 SUNNY SIDE DR
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3640
Mailing Address - Country:US
Mailing Address - Phone:570-216-0864
Mailing Address - Fax:
Practice Address - Street 1:1626 SUNNY SIDE DR
Practice Address - Street 2:
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-3640
Practice Address - Country:US
Practice Address - Phone:570-216-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer