Provider Demographics
NPI:1225176043
Name:JOSHUA POLLACK MD PC
Entity Type:Organization
Organization Name:JOSHUA POLLACK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:POLLACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-859-6500
Mailing Address - Street 1:904 COVENTRY DR
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1974
Mailing Address - Country:US
Mailing Address - Phone:908-859-6500
Mailing Address - Fax:908-859-6538
Practice Address - Street 1:904 COVENTRY DR
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1974
Practice Address - Country:US
Practice Address - Phone:908-859-6500
Practice Address - Fax:908-859-6538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA050600207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ072914Medicare ID - Type Unspecified
PA119115Medicare PIN
NY0357ASMedicare PIN
NJA61826Medicare UPIN