Provider Demographics
NPI:1609322122
Name:POLLACK, KRISTA STARR (MS)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:STARR
Last Name:POLLACK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:KRISTA
Other - Middle Name:STARR
Other - Last Name:CHOJNACKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1845 N FARWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-1793
Mailing Address - Country:US
Mailing Address - Phone:414-225-4478
Mailing Address - Fax:414-225-4476
Practice Address - Street 1:1845 N FARWELL AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-1793
Practice Address - Country:US
Practice Address - Phone:414-225-4478
Practice Address - Fax:414-225-4476
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator