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DR. ELLIOT S POLLACK D.P.M.

>> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1073542312

Individual Registrant:
DR. ELLIOT S POLLACK D.P.M.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
133 HARTFORD AVE  EAST GRANBY, CT 06026-9519 US
Tel: 860-653-4708  Fax: 860-653-6249

Contact information for business:
133 HARTFORD AVE  EAST GRANBY, CT 06026-9519 US
Tel: 860-653-4708  Fax: 860-653-6249

Registration Information:
NPI: 1073542312
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
CT000144

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
TAX ID0610129323CT01
MEDICARE DME0869800001CT01
MEDICARE DME0869800002CT01




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