Scott I Edwin, PH.D.
Individual provider Active NPI Clinical Psychologist · East Norwich, NY
NPI 1720199565 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720199565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 006260-1 (NY)
- Practice address
- 18 Split Oak Dr
East Norwich, NY 11732-1131 - Phone
- (516) 922-1220
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006260-1 | NY | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 006260-1 | NY | Yes |
Addresses
Primary practice location
18 Split Oak Dr
East Norwich, NY 11732-1131
Mailing address
18 Split Oak Dr
East Norwich, NY 11732-1131
Phone (516) 922-1220
Other providers in East Norwich, NY
- Joseph Comitale
- Jennifer Stacy Deneergaard
- Rodney J Dimotta
- Dr Michael Klein & Dr Gideon Tarrash
- Christina Dunne
- Neil Richard Engel
- Lawrence David Epstein
- Esad Optical, Inc
- Excaliber Consulting Inc.
- Kristie M Fazio
All providers in East Norwich, NY · Clinical Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.