Provider Demographics
NPI:1447535273
Name:SHIEL, THOMAS VINCENT (PHD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VINCENT
Last Name:SHIEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 HARRIAD DR W
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1206
Mailing Address - Country:US
Mailing Address - Phone:516-520-8495
Mailing Address - Fax:516-520-8494
Practice Address - Street 1:150 ABBEY LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4042
Practice Address - Country:US
Practice Address - Phone:516-520-8300
Practice Address - Fax:516-520-8367
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009964-1103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool