Healthcare Provider Details

I. General information

NPI: 1730209727
Provider Name (Legal Business Name): STEVEN HOWARD PADNICK PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 HARNED RD
COMMACK NY
11725-3527
US

IV. Provider business mailing address

66 HARNED RD
COMMACK NY
11725-3527
US

V. Phone/Fax

Practice location:
  • Phone: 631-543-8577
  • Fax: 631-543-8573
Mailing address:
  • Phone: 631-543-8577
  • Fax: 631-543-8573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number008998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: