Individual provider Active NPI

Dianne Marie Polowczyk, PH.D.

  • Psychologist
  • Huntington, NY
National Provider Identifier
1528267069
Registry record updated Jul 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
8265 Issued in NY
Practice address
20 Meadowwood CT
Huntington, NY 11743-3829
Phone
(631) 271-6810
Fax
(631) 271-9783
NPI assigned
Jul 14, 2007
Last updated
Jul 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2007

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 8265 NY Primary
Adult Development & Aging Psychologist 103TA0700X 8265 NY
Cognitive & Behavioral Psychologist 103TB0200X 8265 NY
Clinical Psychologist 103TC0700X 8265 NY
Clinical Child & Adolescent Psychologist 103TC2200X 8265 NY
Family Psychologist 103TF0000X 8265 NY
Group Psychotherapy Psychologist 103TP2701X 8265 NY
Health Psychologist 103TH0004X 8265 NY

Addresses

Primary practice location

20 Meadowwood CT
Huntington, NY 11743-3829

Mailing address

20 Meadowwood CT
Huntington, NY 11743-3829
Phone (631) 271-6810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091210000021 NY Practitioner - Clinical Psychologist 5799824488 Practice locations: Huntington, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 Meadowood CT
Huntington, NY 11743-3829
Phone (631) 271-6810

20 Meadowwood CT
Huntington, NY 11743-3829

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
8265NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1184371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184371200000",
    "number": "1528267069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEADOWWOOD CT",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433829",
            "telephone_number": "631-271-6810",
            "fax_number": "631-271-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEADOWWOOD CT",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117433829",
            "telephone_number": "631-271-6810",
            "fax_number": "631-271-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLOWCZYK",
        "first_name": "DIANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-14",
        "last_updated": "2007-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "8265",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NY",
            "license": "8265",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NY",
            "license": "8265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, NY

Sources for this page

Verify at the official NPI Registry.