Provider Demographics
NPI:1437165008
Name:COLEMAN, PAUL WILLIAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WILLIAM
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MARSHALL RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4132
Mailing Address - Country:US
Mailing Address - Phone:845-297-6198
Mailing Address - Fax:845-632-3218
Practice Address - Street 1:11 MARSHALL RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4132
Practice Address - Country:US
Practice Address - Phone:845-297-6198
Practice Address - Fax:845-632-3218
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8367-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV42961Medicare ID - Type Unspecified