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General NPI Number Information
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NPI Number | 1639978307
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Entity Type | Individual
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Provider Name | MARTHA H POLLACK
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 333 E SHORE RD
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City | MANHASSET
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State | NY
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Zip | 11030-2924
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Country | US
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Telephone | 516-814-2666
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Fax |
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Provider Business Mailing Address
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Address Line | 4 STUYVESANT OVAL APT 8B
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City | NEW YORK
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State | NY
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Zip | 10009-2409
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Country | US
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Telephone | 917-689-9053
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R029602-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R-029602-1
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License Number State | NY
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