Provider Demographics
NPI:1437208873
Name:POLLINA, FRANK JOSEPH (OPHTHALMIC DISPENSE)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JOSEPH
Last Name:POLLINA
Suffix:
Gender:M
Credentials:OPHTHALMIC DISPENSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MONTAUK HWY
Mailing Address - Street 2:SUITE 13
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-2128
Mailing Address - Country:US
Mailing Address - Phone:631-399-2020
Mailing Address - Fax:
Practice Address - Street 1:800 MONTAUK HWY
Practice Address - Street 2:SUITE 13
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-2128
Practice Address - Country:US
Practice Address - Phone:631-399-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005336-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0074690Medicaid
NY0074690Medicaid