Provider Demographics
NPI:1700820511
Name:POLLARD, WILLIAM R (PHD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:POLLARD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2661
Mailing Address - Country:US
Mailing Address - Phone:856-589-0221
Mailing Address - Fax:
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2055
Practice Address - Country:US
Practice Address - Phone:856-523-0221
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3111103T00000X, 103TC1900X
PA5551L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0724203000OtherMAGELLAN
PA4554428OtherAETNA PPO AND HMO
NJ0724203000OtherMAGELLAN
PA699076Medicare ID - Type Unspecified