MEDICARE: DR. KEVIN HENRY POLLAK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	25MA06289300	NJ

General Provider Information

NPI Number	:	1104979178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN HENRY POLLAK M.D.

Provider Business Mailing Address
First Line	:	18 MEADOW LN
Second Line	:	LANSDALE
City	:	LANSDALE
State	:	PA
Zip	:	19446-1232
Country	:	US
Telephone Number	:	215-412-7650
Fax Number	:	215-412-2534

Provider Business Practice Location Address
First Line	:	38 W 32ND ST
Second Line	:	SUITE 1200
City	:	NEW YORK
State	:	NY
Zip	:	10001-3816
Country	:	US
Telephone Number	:	800-673-5766
Fax Number	:	800-843-1778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	07/08/2007

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