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General NPI Number Information
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NPI Number | 1912183062
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Entity Type | Organization
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Legal Business Name | STEPHEN B. POLLACK MD
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 1630 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3706
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Country | US
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Telephone | 716-689-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 MAPLE RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-3706
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Country | US
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Telephone | 716-689-8525
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | CECILIA M. LINDNER
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Credential |
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Telephone | 716-689-8525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | C4681
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License Number State | NY
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