Provider Demographics
NPI:1790936938
Name:STEVEN M ESSIG PSYD PA
Entity type:Organization
Organization Name:STEVEN M ESSIG PSYD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ESSIG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-732-7000
Mailing Address - Street 1:107 CANTERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-2251
Mailing Address - Country:US
Mailing Address - Phone:561-732-7000
Mailing Address - Fax:561-536-5753
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-732-7000
Practice Address - Fax:561-731-2997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6865103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6043AMedicare PIN