Individual
ELLEN L POLESHUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-2691
(585) 242-8707
Mailing address
601 ELMWOOD AVE, BOX 668, ROCHESTER, NY 14642-0001
(585) 275-2691
(585) 242-8707
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
014029
NY
103T00000X
Psychologist
14029
NY
103TC0700X
Clinical Psychologist
Primary
014029
NY
207V00000X
Obstetrics & Gynecology Physician
014029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0298561
—
NY
Enumeration date
06/15/2006
Last updated
07/05/2023
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