Provider Demographics
NPI:1952335309
Name:POLLAK, JOSEPH A (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:POLLAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4829
Mailing Address - Country:US
Mailing Address - Phone:201-795-9909
Mailing Address - Fax:201-795-9919
Practice Address - Street 1:323 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4829
Practice Address - Country:US
Practice Address - Phone:201-795-9909
Practice Address - Fax:201-795-9919
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA42852207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7695608Medicaid
NJP00002624Medicare PIN
NJE13082Medicare UPIN