Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 168100-2 | NY |
Y | 207X00000X | Orthopaedic Surgeon | 25MA05804400 | NJ |
NPI | 1023109121 |
---|---|
Provider Name | Roger Gerard Pollock |
First Address | Saddle River, NJ 07458-2602 |
Second Address | Paramus, NJ 07652-2359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F49346 | (02) | NJ |
NS1241 | OXFORD HEALTH PLANS (01) | NJ |