Provider Demographics
NPI:1427002872
Name:VINOCOUR, SUSAN (JD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:
Last Name:VINOCOUR
Suffix:
Gender:F
Credentials:JD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1597 RIDGE RD W
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-2513
Mailing Address - Country:US
Mailing Address - Phone:585-746-4606
Mailing Address - Fax:585-506-9592
Practice Address - Street 1:1597 RIDGE RD W
Practice Address - Street 2:SUITE 301
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-2513
Practice Address - Country:US
Practice Address - Phone:585-746-4606
Practice Address - Fax:585-506-9592
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY104221 FCOtherPREFERRED CARE