Organization
MADISON PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL POLLACK DPM (OWNER)
(917) 873-6483
Entity
Organization
Contact information
Practice address
52 SKYLINE DR, RINGWOOD, NJ 07456-2020
(973) 962-7775
Mailing address
971 WILSON AVE, TEANECK, NJ 07666-1863
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00322600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G300078632
MEDICARE
NJ
Enumeration date
05/25/2017
Last updated
05/25/2017
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