Dr. Mark Lederway
Clinical Psychologist
325 E Main St
Smithtown
, New York 11787-2922
Dr. Mark Lederway
Clinical Psychologist
325 E Main St
Smithtown
, New York 11787-2922
(631) 979-0965
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Mark Lederway
- 325 E Main St
- Smithtown, NY
- Zip : 11787-2922
- Phone : (631) 979-0965
Second Address
- Dr. Mark Lederway
- 325 E Main St
- Smithtown, NY
- Zip : 11787-2922
- Phone : (631) 979-0965
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 005384 | NY |
| Y | 103TC0700X | Clinical Psychologist | 005384 | NY |
National Provider Identifier
| NPI | 1003954470 |
|---|---|
| Provider Name | Dr. Mark Lederway |
| First Address | Smithtown, NY 11787-2922 |
| Second Address | Smithtown, NY 11787-2922 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0001086 | GHI PIN# (01) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.