Individual
DR. MATTHEW BRUCE POLLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
475 EAST MAIN STREET, SUITE 214, PATCHOGUE, NY 11772
(631) 654-8507
(631) 654-8507
Mailing address
475 EAST MAIN STREET, SUITE 214, PATCHOGUE, NY 11772
(631) 654-8507
(631) 654-8507
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0090071
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014738859
—
NY
Enumeration date
08/31/2006
Last updated
11/18/2011
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