Healthcare Provider Details

I. General information

NPI: 1427156314
Provider Name (Legal Business Name): EMIL MARTIN POLLAK JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 SAINT JOHNSBURY RD DARTMOUTH-HITCHCOCK CLINIC, SUITE A
LITTLETON NH
03561-3437
US

IV. Provider business mailing address

580 SAINT JOHNSBURY RD SUITE A- DARTMOUTH-HITCHCOCK LITTLETON CARDIOLOGY
LITTLETON NH
03561-3437
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-9390
  • Fax:
Mailing address:
  • Phone: 603-444-9390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number7818
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: