Provider Demographics
NPI:1407135098
Name:POLLACK, ELIANNA CHAYA (DPT)
Entity Type:Individual
Prefix:MRS
First Name:ELIANNA
Middle Name:CHAYA
Last Name:POLLACK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15012 JEWEL AVE APT 1L
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1434
Mailing Address - Country:US
Mailing Address - Phone:917-324-9083
Mailing Address - Fax:
Practice Address - Street 1:15012 JEWEL AVE APT 1L
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1434
Practice Address - Country:US
Practice Address - Phone:917-324-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033350-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist