Provider Demographics
NPI:1932145463
Name:NADULEK, STANLEY HOWARD (PHD, PC)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:HOWARD
Last Name:NADULEK
Suffix:
Gender:M
Credentials:PHD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4068 MOUNT ROYAL BLVD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-2977
Mailing Address - Country:US
Mailing Address - Phone:412-487-1710
Mailing Address - Fax:724-444-3047
Practice Address - Street 1:4068 MOUNT ROYAL BLVD
Practice Address - Street 2:SUITE 218
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-2977
Practice Address - Country:US
Practice Address - Phone:412-487-1710
Practice Address - Fax:724-444-3047
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-005306-L103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA41-001530638Medicaid
PA41-001530638Medicaid