Healthcare Provider Details

I. General information

NPI: 1558776856
Provider Name (Legal Business Name): REBECCA POLLACK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 07/25/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF TENNESSEE HEALTH SCIENCE CTR SUITE 447
MEMPHIS TN
38163-0001
US

IV. Provider business mailing address

LINCOLN HOSPITAL MEDICAL CENTER 234 EAST 149TH ST
BRONX NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-5265
  • Fax:
Mailing address:
  • Phone: 718-579-3045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number290996
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: