Provider Demographics
NPI:1811953185
Name:PARADIS, CHERYL (PSY D)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:PARADIS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 050 145
Mailing Address - Street 2:
Mailing Address - City:PRATT STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11205-0001
Mailing Address - Country:US
Mailing Address - Phone:718-624-4281
Mailing Address - Fax:
Practice Address - Street 1:451 CLARKSON AVE
Practice Address - Street 2:KINGS COUNTY HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-245-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0086371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist