Provider Demographics
NPI:1053342147
Name:POLLACK, JEAN F (MS)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:F
Last Name:POLLACK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2505
Mailing Address - Country:US
Mailing Address - Phone:717-873-1248
Mailing Address - Fax:
Practice Address - Street 1:260 LYNBROOK DR N
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3228
Practice Address - Country:US
Practice Address - Phone:717-873-1248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001849609-001OtherPSYCHOLOGIST