Provider Demographics
NPI:1629227103
Name:POLLARD, RAY JR (LMT)
Entity Type:Individual
Prefix:MR
First Name:RAY
Middle Name:
Last Name:POLLARD
Suffix:JR
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3202
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12402-3202
Mailing Address - Country:US
Mailing Address - Phone:845-679-1253
Mailing Address - Fax:845-679-3217
Practice Address - Street 1:1314 RT. 28
Practice Address - Street 2:
Practice Address - City:WEST HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12491
Practice Address - Country:US
Practice Address - Phone:845-679-1253
Practice Address - Fax:845-679-3217
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY005081-1247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005081-1OtherUNIVERSITY OF THE STATE OF NY EDUCATION DEPARTMENT