Individual
DR. ETHAN POLLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
992 GREAT PLAIN AV, NEEDHAM, MA 02492
(781) 449-4280
(781) 449-3134
Mailing address
992 GREAT PLAIN AV, NEEDHAM, MA 02492
(781) 449-4280
(781) 449-3134
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
837
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
668081
TUFTS
MA
Enumeration date
10/04/2006
Last updated
07/08/2007
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