Susan J. Polino, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015546-1 Issued in NY

Practice address

601 Elmwood Avenue
Box 278984
Rochester, NY 14620-0001

Phone

(585) 275-8503

Fax

(585) 276-2249

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Susan Jean Maher Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• U of R Neurology Department

  • Neurology Physician
  • Rochester, NY
  • NPI 1184725525
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1255427894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 MT. HOPE AVENUE",
            "address_2": "SUITE 116",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146203917",
            "telephone_number": "585-275-8503",
            "fax_number": "585-276-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE",
            "address_2": "BOX 278984",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146200001",
            "telephone_number": "585-275-8503",
            "fax_number": "585-276-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLINO",
        "first_name": "SUSAN",
        "middle_name": "J.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015546-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "MAHER",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Poleshuck, OTD
• Victor A Poleshuck, M.D.
• Joseph John Poli, MD
• Galina Polina
• Katherine K Polino, R.N., M.S., N.P.
• Rivka Polisky, LCAT, ATR-BC
• Erin Marie Polito, PA
• Lucas Polito, PA-C
• Rachel Anna Polito, PT, DPT
• Jenna Marie Polizzi, LPN

• Clinical Psychologist in Rochester, NY
• Providers in Rochester, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.