Provider Demographics
NPI:1205024338
Name:STEVEN J POLLACK DC PA
Entity Type:Organization
Organization Name:STEVEN J POLLACK DC PA
Other - Org Name:DBA POLLACK CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLLACK
Authorized Official - Suffix:
Authorized Official - Credentials:DC PA
Authorized Official - Phone:732-244-0222
Mailing Address - Street 1:137 ATLANTIC CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-2935
Mailing Address - Country:US
Mailing Address - Phone:732-244-0222
Mailing Address - Fax:732-244-0450
Practice Address - Street 1:137 ATLANTIC CITY BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-2935
Practice Address - Country:US
Practice Address - Phone:732-244-0222
Practice Address - Fax:732-244-0450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVEN J POLLACK DC PA DBA POLLACK CHIROPRACTIC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-15
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC02264111N00000X
NJ38MC00226400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087685Medicare PIN