Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 210835 | NY |
NPI | 1255411815 |
---|---|
Provider Name | Staci E Pollack |
First Address | Larchmont, NY 10538-1216 |
Second Address | Hartsdale, NY 10530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 17/11/2011 |