Healthcare Provider Details

I. General information

NPI: 1003951328
Provider Name (Legal Business Name): STEPHEN JOSEPH POLLAK CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2235 E PERSHING ST
SALEM OH
44460-3478
US

IV. Provider business mailing address

PO BOX 1211
SALEM OH
44460-8211
US

V. Phone/Fax

Practice location:
  • Phone: 330-337-8333
  • Fax: 330-337-8373
Mailing address:
  • Phone: 330-337-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberLPO-0097
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberLPO-0097
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: