NPIMap

Organization Active NPI

Pollack

  • Neurology Physician
  • Enfield, CT
National Provider Identifier
1861670275
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
041022 Issued in CT
Legal business name
POLLACK
Practice address
1699 King St
Suite 208
Enfield, CT 06082-6051
Phone
(860) 749-5881
Fax
(860) 776-2420
NPI assigned
Feb 7, 2008
Last updated
Jul 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Ira A PollackNPI 1760459614
Title
Owner
Phone
(860) 749-5881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084N0400X 041022 CT Primary
Sleep Medicine (Psychiatry & Neurology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084S0012X 041022 CT

Addresses

Primary practice location

1699 King St
Suite 208
Enfield, CT 06082-6051

Mailing address

1699 King Street
Suite 208
Enfield, CT 06082-4585
Phone (860) 749-5881

Other identifiers 1

IdentifierTypeStateIssuer
001410224MedicaidCT

National Provider Directory

National Provider Directory

Locations

1699 King St
Ste 208
Enfield, CT 06082
Phone (860) 749-5881

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1861670275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 KING STREET",
            "address_2": "SUITE 208",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824585",
            "telephone_number": "860-749-5881",
            "fax_number": "860-776-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1699 KING ST",
            "address_2": "SUITE 208",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060826051",
            "telephone_number": "860-749-5881",
            "fax_number": "860-776-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLLACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "POLLACK",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-749-5881"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "041022",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "CT",
            "license": "041022",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001410224",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.