| Doctor Name: | DR. CHARLES POLAK |
| NPI Number: | 1003974767 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 25MA03464300 |
| Business Practice Address: | 328 W Saint Georges Ave Linden, NJ - 070365638 |
| Business Phone Number: | 9089257519 |
| Business Fax Number: | 9089252842 |
| Mailing Address: | 328 W Saint Georges Ave, LINDEN |
| State: | NJ |
| Postal Code: | 070365638 |
| Phone Number: | 9089257519 |
| Fax Number: | 9089252842 |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 03/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 170100000X |
| License Number: | 25MA03464300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Medical Genetics, Ph.D. Medical Genetics |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to medical and dental specialists. |