MEDICARE: ANDREW K POLLACK

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	207N00000X	Dermatology Physician	MD022348E	PA

General Provider Information

NPI Number	:	1760555924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW K POLLACK

Provider Business Mailing Address
First Line	:	501 OFFICE CENTER DR
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-3220
Country	:	US
Telephone Number	:	215-836-7900
Fax Number	:	215-836-0119

Provider Business Practice Location Address
First Line	:	501 OFFICE CENTER DR
Second Line	:	SUITE 195
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-3220
Country	:	US
Telephone Number	:	215-836-7900
Fax Number	:	215-836-0119

Authorized Official
Title or Position	:	DIRECTOR OWNER
Name	:	DR. ANDREW K POLLACK
Credential	:	M.D.
Telephone Number	:	215-836-7900

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	11/25/2007

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