Provider Demographics
NPI:1528382330
Name:POLLINA, ROBERTO (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:POLLINA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 13TH AVE
Mailing Address - Street 2:POLLINA PHARMACY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-1609
Mailing Address - Country:US
Mailing Address - Phone:718-331-4300
Mailing Address - Fax:718-331-1400
Practice Address - Street 1:7601 13TH AVE
Practice Address - Street 2:POLLINA PHARMACY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-1609
Practice Address - Country:US
Practice Address - Phone:718-331-4300
Practice Address - Fax:718-331-1400
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02616622Medicaid