Healthcare Provider Details

I. General information

NPI: 1205918042
Provider Name (Legal Business Name): SHELDON SCHMIDT PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 GOLDFINCH LN
HUNTINGTON NY
11743-6506
US

IV. Provider business mailing address

11 GOLDFINCH LN
HUNTINGTON NY
11743-6506
US

V. Phone/Fax

Practice location:
  • Phone: 631-692-4858
  • Fax:
Mailing address:
  • Phone: 631-692-4858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number006094-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: