Provider Demographics
NPI:1972680122
Name:POLIN, LINDA C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:POLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2401
Mailing Address - Country:US
Mailing Address - Phone:215-646-5349
Mailing Address - Fax:
Practice Address - Street 1:1012 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:SPRING HOUSE
Practice Address - State:PA
Practice Address - Zip Code:19477-0086
Practice Address - Country:US
Practice Address - Phone:215-646-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003178L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101331OtherBLUE SHIELD
PA0004528039OtherAETNA
PA2350978000OtherPERSONAL CHOICE
PA101331OtherBLUE SHIELD
PAR06066Medicare UPIN