Provider Demographics
NPI:1497978308
Name:POLLACK, JANINE MELODY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANINE
Middle Name:MELODY
Last Name:POLLACK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JANINE
Other - Middle Name:MELODY
Other - Last Name:POLLACK-MELTZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:710 W END AVE
Mailing Address - Street 2:APT 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6808
Mailing Address - Country:US
Mailing Address - Phone:718-237-2333
Mailing Address - Fax:718-237-8813
Practice Address - Street 1:26 COURT ST
Practice Address - Street 2:SUITE 512
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11242-0103
Practice Address - Country:US
Practice Address - Phone:718-237-2333
Practice Address - Fax:718-237-8813
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9737-1103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist