Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 017866 | NY |
Y | 103TC0700X | Clinical Psychologist | 017866 | NY |
NPI | 1013152131 |
---|---|
Provider Name | Eric Padol |
First Address | Carle Place, NY 11514-1801 |
Second Address | Yonkers, NY 10703-3102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2008 |
Last Update Date | 13/06/2019 |