Provider Demographics
NPI:1629063052
Name:POLLACK, ALAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:POLLACK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:SUITE 416
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1313
Mailing Address - Country:US
Mailing Address - Phone:703-751-0700
Mailing Address - Fax:703-751-2020
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-751-0700
Practice Address - Fax:703-751-2020
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2010-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101225387207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
286919OtherMAMSI/ALLIANCE
140021OtherANTHEM
VA6300162Medicaid
A937-0002OtherCAREFIRST
7125122OtherAETNA PPO
345382OtherNCPPO
540947194OtherUNITED HEALTH
2391760OtherAETNA HMO
140021OtherANTHEM
VA6300162Medicaid