Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | P76157 | NY |
NPI | 1548515315 |
---|---|
Provider Name | Dr. Daniel Pollack |
First Address | Bergenfield, NJ 07621-3902 |
Second Address | Brooklyn, NY 11237-4006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 18/07/2012 |