Organization Active NPI

Tracey Polizzi, Psychology PH.D., P.C.

  • Clinical Psychologist
  • Blauvelt, NY
National Provider Identifier
1396038923
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017793 Issued in NY
Legal business name
TRACEY POLIZZI, PSYCHOLOGY PH.D., P.C.
Practice address
572 Route 303
Blauvelt, NY 10913-1941
Phone
(845) 398-0934
Fax
(845) 398-0913
NPI assigned
May 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Authorized official

Name
Dr. Tracey Polizzi, PH.D.
Title
President
Phone
(845) 825-9491

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 017793 NY Primary

Addresses

Primary practice location

572 Route 303
Blauvelt, NY 10913-1941

Mailing address

30 Minerick Dr
Stony Point, NY 10980-1821
Phone (845) 825-9491

National Provider Directory

National Provider Directory

Locations

572 Route 303
Blauvelt, NY 10913
Phone (845) 398-0934

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1396038923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MINERICK DR",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109801821",
            "telephone_number": "845-825-9491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 ROUTE 303",
            "city": "BLAUVELT",
            "state": "NY",
            "postal_code": "109131941",
            "telephone_number": "845-398-0934",
            "fax_number": "845-398-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACEY POLIZZI, PSYCHOLOGY PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "POLIZZI",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-825-9491",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blauvelt, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.