Provider Demographics
NPI:1477748895
Name:POLLOCK, ROBIN M (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:M
Last Name:POLLOCK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 SOMES PATH
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:NY
Mailing Address - Zip Code:13080-3164
Mailing Address - Country:US
Mailing Address - Phone:315-689-5018
Mailing Address - Fax:
Practice Address - Street 1:353 SOMES PATH
Practice Address - Street 2:
Practice Address - City:JORDAN
Practice Address - State:NY
Practice Address - Zip Code:13080-3164
Practice Address - Country:US
Practice Address - Phone:315-689-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY580903-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02841138Medicaid