Healthcare Provider Details

I. General information

NPI: 1831351782
Provider Name (Legal Business Name): POLLACK HEALTH AND WELLNESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 ATLANTIC CITY BLVD
BEACHWOOD NJ
08722-2935
US

IV. Provider business mailing address

137 ATLANTIC CITY BLVD
BEACHWOOD NJ
08722-2935
US

V. Phone/Fax

Practice location:
  • Phone: 732-244-0222
  • Fax: 732-244-0450
Mailing address:
  • Phone: 732-244-0222
  • Fax: 732-244-0450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number38MC00226400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: STEVEN J POLLACK
Title or Position: PRESIDENT
Credential: DC
Phone: 732-244-0222