Individual
DR. H. TAD TROUTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
31 OAK ST, SUITE 21, PATCHOGUE, NY 11772-2841
(631) 598-9217
(866) 586-3157
Mailing address
31 OAK ST, SUITE 21, PATCHOGUE, NY 11772-2841
(631) 598-9217
(866) 586-3157
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
017613
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02981244
—
NY
01
—
1089280
AFFINITY HEALTH PLAN
NY
01
—
60054
AETNA
NY
Enumeration date
04/28/2008
Last updated
05/10/2012
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