Organization Active NPI

Mark Pollack OD PA

  • Optometrist
  • Newark, NJ
National Provider Identifier
1154525111
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARK POLLACK OD PA
Practice address
106 Ferry St
Newark, NJ 07105-2106
Phone
(973) 589-8085
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark Pollack, OD
Title
Owner
Phone
(973) 344-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

106 Ferry St
Newark, NJ 07105-2106

Mailing address

106 Ferry St
Newark, NJ 07105-2106
Phone (973) 344-2212

Other practice location 1

279 Ferry St
Newark, NJ 07105-3400
Phone (973) 344-2212

National Provider Directory

National Provider Directory

Locations

100 Main St
Woodbridge, NJ 07095
Phone (732) 750-4520

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1154525111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052106",
            "telephone_number": "973-344-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071052106",
            "telephone_number": "973-589-8085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "279 Ferry St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071053400",
            "country_code": "US",
            "telephone_number": "973-344-2212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARK POLLACK OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-344-2212",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.