Healthcare Provider Details

I. General information

NPI: 1013152131
Provider Name (Legal Business Name): ERIC PADOL PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 PALISADE AVE
YONKERS NY
10703-3102
US

IV. Provider business mailing address

1 OLD COUNTRY RD SUITE 271
CARLE PLACE NY
11514-1801
US

V. Phone/Fax

Practice location:
  • Phone: 914-966-1300
  • Fax:
Mailing address:
  • Phone: 800-725-6280
  • Fax: 800-725-6380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number017866
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: