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General NPI Number Information
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NPI Number | 1063602118
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Entity Type | Individual
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Provider Name | SCOTT MICHAEL SOKOL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 411 W 114TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-1710
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Country | US
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Telephone | 508-505-8677
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Fax |
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Provider Business Mailing Address
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Address Line | 815 PEPPERIDGE RD
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City | WESTBURY
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State | NY
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Zip | 11590-1436
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Country | US
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Telephone | 508-505-8677
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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 | 011864
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 6314
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License Number State | MA
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