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General NPI Number Information
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NPI Number | 1740184555
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Entity Type | Individual
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Provider Name | NICOLE POLLOCK
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Gender | Female
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 90 MAIN ST STE 108A
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City | CENTERBROOK
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State | CT
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Zip | 06409-1057
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Country | US
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Telephone | 860-227-5051
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Fax |
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Provider Business Mailing Address
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Address Line | 3 RAILROAD AVE
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City | CHESTER
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State | CT
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Zip | 06412-1216
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Country | US
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Telephone | 860-227-5051
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 48.003838
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License Number State | CT
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