Provider Demographics
NPI:1194485086
Name:POLLAK, KAREN SHULAMIS
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SHULAMIS
Last Name:POLLAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3203
Mailing Address - Country:US
Mailing Address - Phone:551-404-5734
Mailing Address - Fax:
Practice Address - Street 1:MAAPELEI EGOZ 12 BET APT 1
Practice Address - Street 2:
Practice Address - City:BEIT SHEMESH
Practice Address - State:ISRAEL
Practice Address - Zip Code:99999
Practice Address - Country:IL
Practice Address - Phone:053-524-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019905-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical