| Alexander Bory Phd Pc | |
|
1119 Caroline St Fredericksburg VA 22401-3815 | |
| (540) 371-2251 | |
| (540) 371-2930 |
| Full Name | Alexander Bory Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1119 Caroline St, Fredericksburg, Virginia |
| Authorized Official Name and Position | Alexander Bory (OWNER) |
| Authorized Official Contact | 5403712251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Bory Phd Pc 1119 Caroline St Fredericksburg VA 22401-3815 Ph: (540) 371-2251 | Alexander Bory Phd Pc 1119 Caroline St Fredericksburg VA 22401-3815 Ph: (540) 371-2251 |
| NPI Number | 1487916284 |
|---|---|
| Provider Enumeration Date | 06/08/2012 |
| Last Update Date | 06/08/2012 |
| Medicare PECOS PAC ID | 8820252547 |
|---|---|
| Medicare Enrollment ID | O20120608000550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487916284 | NPI | - | NPPES |
| 007701764 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810001956 (Virginia) | Primary |
| Provider Name | Alexander Bory |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437170305 PECOS PAC ID: 4183885767 Enrollment ID: I20120406000281 |
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