Provider Demographics
NPI:1235692393
Name:POLLACK, KARLYN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:KARLYN
Middle Name:ELIZABETH
Last Name:POLLACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 WHITTIER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4540
Mailing Address - Country:US
Mailing Address - Phone:703-992-9211
Mailing Address - Fax:
Practice Address - Street 1:6711 WHITTIER AVE STE 101
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4540
Practice Address - Country:US
Practice Address - Phone:703-992-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-07
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101281132207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty