Provider Demographics
NPI:1205452810
Name:POLLARD, NICHOLE ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:NICHOLE
Middle Name:ELIZABETH
Last Name:POLLARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MERRITT PL
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2032
Mailing Address - Country:US
Mailing Address - Phone:315-525-9668
Mailing Address - Fax:
Practice Address - Street 1:1320 FLOYD AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440
Practice Address - Country:US
Practice Address - Phone:315-337-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009147152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist