Provider Demographics
NPI:1851450845
Name:POLLACK, DARREN KEITH (DC)
Entity Type:Individual
Prefix:DR
First Name:DARREN
Middle Name:KEITH
Last Name:POLLACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 57TH ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2049
Mailing Address - Country:US
Mailing Address - Phone:212-755-5500
Mailing Address - Fax:212-755-0505
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:SUITE 520
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:212-755-5500
Practice Address - Fax:212-755-0505
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008979111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP918400OtherOXFORD
NY5899703OtherGHI
NYX6A421Medicare ID - Type Unspecified
NY5899703OtherGHI