Provider Demographics
NPI:1295898708
Name:POLLOCK, SYLVIA W (PHD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:W
Last Name:POLLOCK
Suffix:
Gender:F
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:PO BOX 2272
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-2272
Mailing Address - Country:US
Mailing Address - Phone:603-447-4258
Mailing Address - Fax:603-447-8907
Practice Address - Street 1:2977 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5111
Practice Address - Country:US
Practice Address - Phone:603-447-4258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1088103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH06Y010583NH01OtherANTHEM INDEMNITY
06Y010583NH01OtherANTHEM MANAGED CARE
NH06Y010583NH01OtherBCBSNH NEW ENGLAND
NH30424631Medicaid