=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922147651
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARYEH L. POLLACK, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2007
-----------------------------------------------------
Last Update Date | 05/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 345 E 37TH ST RM 212
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-3256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-439-9009
-----------------------------------------------------
Fax | 212-867-3862
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 345 E 37TH ST RM 212
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-3256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-439-9009
-----------------------------------------------------
Fax | 212-867-3862
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ARYEH L POLLACK
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 212-439-9009
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 204011
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------