| Bhcofwny | |
|
5178 Parker Rd Hamburg NY 14075-1633 | |
| (716) 598-8827 | |
| Not Available |
| Full Name | Bhcofwny |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 5178 Parker Rd, Hamburg, New York |
| Authorized Official Name and Position | Charles Jack (OWNER/SOLE PROPRIETOR) |
| Authorized Official Contact | 7165988827 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bhcofwny 5178 Parker Rd Hamburg NY 14075-1633 Ph: (716) 598-8827 | Bhcofwny 5178 Parker Rd Hamburg NY 14075-1633 Ph: (716) 598-8827 |
| NPI Number | 1689393191 |
|---|---|
| Provider Enumeration Date | 08/26/2022 |
| Last Update Date | 08/26/2022 |
| Certification Date | 05/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689393191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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