Provider Demographics
NPI:1497729065
Name:POLLACK, STEVEN J
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:POLLACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ATLANTIC CITY BLVD
Mailing Address - Street 2:STE. 1
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-2935
Mailing Address - Country:US
Mailing Address - Phone:732-244-0222
Mailing Address - Fax:732-244-0450
Practice Address - Street 1:137 ATLANTIC CITY BLVD
Practice Address - Street 2:STE. 1
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-2935
Practice Address - Country:US
Practice Address - Phone:732-244-0222
Practice Address - Fax:732-244-0450
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00226400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ449237Medicare ID - Type Unspecified