Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 68010899 | NY |
NPI | 1043529563 |
---|---|
Provider Name | Dr. Rick Martin Schwabish |
First Address | Stony Brook, NY 11790-1535 |
Second Address | Stony Brook, NY 11790-1535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 30/09/2010 |