Individual
EDWARD JOSEPH SCHORK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
523 E PUTNAM AVE, SUITE 24, GREENWICH, CT 06830-4877
(203) 448-9742
Mailing address
34 SLEEPY HOLLOW DR, DANBURY, CT 06810-5361
(203) 448-9742
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
001636
CT
103TB0200X
Cognitive & Behavioral Psychologist
008855
NY
103TC0700X
Clinical Psychologist
Primary
001636
CT
103TC0700X
Clinical Psychologist
008855
NY
103TC2200X
Clinical Child & Adolescent Psychologist
001636
CT
103TC2200X
Clinical Child & Adolescent Psychologist
08855
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01802088
—
NY
Enumeration date
05/16/2006
Last updated
09/21/2015
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