Provider Demographics
NPI:1437399904
Name:POLLACK, BRIAN TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TODD
Last Name:POLLACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1301
Mailing Address - Country:US
Mailing Address - Phone:860-832-8625
Mailing Address - Fax:860-832-8673
Practice Address - Street 1:17 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1301
Practice Address - Country:US
Practice Address - Phone:860-832-8625
Practice Address - Fax:860-832-8673
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001637111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation