NPIMap

Organization Active NPI

H. Tad Troutman, PH.D., Psychologist, PLLC

  • Clinical Psychologist
  • Bay Shore, NY
National Provider Identifier
1033434782
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017613 Issued in NY
Legal business name
H. TAD TROUTMAN, PH.D., PSYCHOLOGIST, PLLC
Practice address
10 Brentwood Rd
Suite 2
Bay Shore, NY 11706-8022
Phone
(631) 968-7700
NPI assigned
Apr 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. H. Tad Troutman, PH.D.
Title
Clinical Psychologist
Phone
(631) 968-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 017613 NY Primary

Addresses

Primary practice location

10 Brentwood Rd
Suite 2
Bay Shore, NY 11706-8022

Mailing address

10 Brentwood Rd
Suite 2
Bay Shore, NY 11706-8022
Phone (631) 968-7700

National Provider Directory

National Provider Directory

Locations

31 Oak St
Ste 21
Patchogue, NY 11772
Phone (631) 447-6425

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1033434782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRENTWOOD RD",
            "address_2": "SUITE 2",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068022",
            "telephone_number": "631-968-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BRENTWOOD RD",
            "address_2": "SUITE 2",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068022",
            "telephone_number": "631-968-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. TAD TROUTMAN, PH.D., PSYCHOLOGIST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "TROUTMAN",
        "authorized_official_first_name": "H.",
        "authorized_official_middle_name": "TAD",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "631-968-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.