Provider Demographics
NPI:1891031365
Name:PADILLA, ELVIN MICHAEL JR (TSHH)
Entity Type:Individual
Prefix:MR
First Name:ELVIN
Middle Name:MICHAEL
Last Name:PADILLA
Suffix:JR
Gender:M
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 COZINE AVE
Mailing Address - Street 2:APT. 5F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-9238
Mailing Address - Country:US
Mailing Address - Phone:718-440-5232
Mailing Address - Fax:
Practice Address - Street 1:380 COZINE AVE
Practice Address - Street 2:APT. 5F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-9238
Practice Address - Country:US
Practice Address - Phone:718-440-5232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY812519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist