Provider Demographics
NPI:1306027479
Name:POLLACK, MOREY (RPH)
Entity Type:Individual
Prefix:
First Name:MOREY
Middle Name:
Last Name:POLLACK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CHITTENANGO
Mailing Address - State:NY
Mailing Address - Zip Code:13037-8505
Mailing Address - Country:US
Mailing Address - Phone:315-687-3841
Mailing Address - Fax:315-687-7513
Practice Address - Street 1:10739 PORT WATSON ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045
Practice Address - Country:US
Practice Address - Phone:607-756-7591
Practice Address - Fax:315-687-7513
Is Sole Proprietor?:No
Enumeration Date:2007-11-17
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY34229-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist