| Organization Name: | H. TAD TROUTMAN, PH.D., PSYCHOLOGIST, PLLC |
| NPI Number: | 1033434782 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | H. TAD TROUTMAN (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 10 Brentwood Rd Suite 2 Bay Shore |
| State: | NY US |
| Postal Code: | 117068022 |
| Phone Number: | 6319687700 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2010 |
| NPI Last Update Date: | 11/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 017613 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |