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NPI Code Detail

MEDICARE: NICOLE POLLACK MS,RD,LD

MEDICARE: NICOLE POLLACK MS,RD,LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian09202OH

General Provider Information

NPI Number : 1023780012
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE POLLACK MS,RD,LD
Provider Business Mailing Address
First Line : 5411 MEADOW WOOD BLVD
Second Line :
City : LYNDHURST
State : OH
Zip : 44124-3706
Country : US
Telephone Number : 440-823-5837
Fax Number :
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-1078
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 12/23/2025

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