Provider Demographics
NPI:1255687422
Name:POLLAK, AHUVA (MS)
Entity Type:Individual
Prefix:MRS
First Name:AHUVA
Middle Name:
Last Name:POLLAK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3610
Mailing Address - Country:US
Mailing Address - Phone:845-834-1011
Mailing Address - Fax:
Practice Address - Street 1:14 MEADOW LN
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3610
Practice Address - Country:US
Practice Address - Phone:845-834-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1871403174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist