Provider Demographics
NPI:1619405644
Name:POLLACK, EMILY (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:POLLACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 KINNELON RD RM 28A
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405-2351
Mailing Address - Country:US
Mailing Address - Phone:973-838-0001
Mailing Address - Fax:973-838-7650
Practice Address - Street 1:170 KINNELON RD RM 28
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2351
Practice Address - Country:US
Practice Address - Phone:973-838-1717
Practice Address - Fax:973-838-1775
Is Sole Proprietor?:No
Enumeration Date:2017-06-04
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10829400208000000X, 207P00000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine