MEDICARE: DR. CARY SCOTT POLLACK 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	207RC0000X	Cardiovascular Disease Physician	148399	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285734855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARY SCOTT POLLACK M.D.

Provider Business Mailing Address
First Line	:	72 YALE ST
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2448
Country	:	US
Telephone Number	:	516-625-3108
Fax Number	:	212-781-0513

Provider Business Practice Location Address
First Line	:	3131 GRAND CONCOURSE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-1442
Country	:	US
Telephone Number	:	718-295-7900
Fax Number	:	212-781-0513

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	12/02/2015

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