Healthcare Provider Details
I. General information
NPI: 1023003233
Provider Name (Legal Business Name): STUART N POLLACK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/14/2005
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 OSTRUM ST
BETHLEHEM PA
18015-1000
US
IV. Provider business mailing address
PO BOX 130
JAMISON PA
18929-0130
US
V. Phone/Fax
- Phone: 215-918-0060
- Fax: 215-918-0063
- Phone: 215-918-0060
- Fax: 215-918-0063
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | MD054086L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | MD054086L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: