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General NPI Number Information
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NPI Number | 1023418159
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Entity Type | Individual
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Provider Name | HILLARY R SCUDDER PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 01/14/2022
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Provider Practice Location Address
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Address Line | 132 E MAIN ST
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City | BAY SHORE
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State | NY
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Zip | 11706-8302
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Country | US
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Telephone | 631-647-2530
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Fax |
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Provider Business Mailing Address
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Address Line | 85 GEORGE ST
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City | BABYLON
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State | NY
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Zip | 11702-2911
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Country | US
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Telephone | 914-844-8926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 022741
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License Number State | NY
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