Provider Demographics
NPI:1295721850
Name:POLLAN, STUART JOEL (OD06)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:JOEL
Last Name:POLLAN
Suffix:
Gender:M
Credentials:OD06
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2308
Mailing Address - Country:US
Mailing Address - Phone:610-395-2474
Mailing Address - Fax:610-351-2665
Practice Address - Street 1:1405 N CEDAR CREST BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2308
Practice Address - Country:US
Practice Address - Phone:610-395-2474
Practice Address - Fax:610-351-2665
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000986152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT-27321Medicare UPIN
PAPOO43834Medicare ID - Type Unspecified