Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 020735 | NY |
Y | 103G00000X | Clinical Psychologist | 020735 | NY |
Y | 103TC0700X | Clinical Psychologist | 020735 | NY |
N | 103TC1900X | Counseling Psychologist | 020735 | NY |
NPI | 1366851909 |
---|---|
Provider Name | Dr. James Albert Pollock IV |
First Address | New York, NY 10010-3206 |
Second Address | New York, NY 10010-3206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2014 |
Last Update Date | 10/09/2014 |