Provider Demographics
NPI:1417023524
Name:ARTHUR PODWALL PH.D., LLC
Entity type:Organization
Organization Name:ARTHUR PODWALL PH.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST & SPEECH PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:PODWALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-360-3222
Mailing Address - Street 1:17 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1903
Mailing Address - Country:US
Mailing Address - Phone:631-360-0033
Mailing Address - Fax:631-780-5985
Practice Address - Street 1:17 CRAWFORD ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1903
Practice Address - Country:US
Practice Address - Phone:631-360-0033
Practice Address - Fax:631-780-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty