Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 084860 | NY |
NPI | 1164524757 |
---|---|
Provider Name | Bernard Pollock |
First Address | Wantagh, NY 11793-2209 |
Second Address | Wantagh, NY 11793-2209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2006 |
Last Update Date | 29/10/2010 |