Healthcare Provider Details

I. General information

NPI: 1750537510
Provider Name (Legal Business Name): PATRICIA POLOSKY RN, SNII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 LONG POND RD
ROCHESTER NY
14626-4122
US

IV. Provider business mailing address

1565 LONG POND RD
ROCHESTER NY
14626-4122
US

V. Phone/Fax

Practice location:
  • Phone: 585-723-7723
  • Fax:
Mailing address:
  • Phone: 585-723-7723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number374023
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: