Provider Demographics
NPI:1376860106
Name:POLLARD, ALDERINE PHYLISSIA
Entity Type:Individual
Prefix:
First Name:ALDERINE
Middle Name:PHYLISSIA
Last Name:POLLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 4TH ST
Mailing Address - Street 2:APT 5E
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-3656
Mailing Address - Country:US
Mailing Address - Phone:914-664-1327
Mailing Address - Fax:
Practice Address - Street 1:160 E 4TH ST
Practice Address - Street 2:APT 5E
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-3656
Practice Address - Country:US
Practice Address - Phone:914-664-1327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY295398-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse