Provider Demographics
NPI:1366472946
Name:POLLACK, MARSHALL SANDY (MKD)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:SANDY
Last Name:POLLACK
Suffix:
Gender:M
Credentials:MKD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1718
Mailing Address - Country:US
Mailing Address - Phone:973-467-9440
Mailing Address - Fax:973-376-1680
Practice Address - Street 1:233 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1718
Practice Address - Country:US
Practice Address - Phone:973-467-9440
Practice Address - Fax:973-376-1680
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA035089207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology