| Dmitri Bougakov Ph.d. Psychology Pllc | |
|
315 W 57th St Suite 401 New York NY 10019-3158 | |
| (212) 541-6412 | |
| Not Available |
| Full Name | Dmitri Bougakov Ph.d. Psychology Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 315 W 57th St, New York, New York |
| Authorized Official Name and Position | Dmitri Bougakov (SOLE PROPRIETOR) |
| Authorized Official Contact | 6464968963 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dmitri Bougakov Ph.d. Psychology Pllc 340 E Mosholu Pkwy S Apartment 6g Bronx NY 10458-1742 Ph: (646) 496-8963 | Dmitri Bougakov Ph.d. Psychology Pllc 315 W 57th St Suite 401 New York NY 10019-3158 Ph: (212) 541-6412 |
| NPI Number | 1326287426 |
|---|---|
| Provider Enumeration Date | 02/12/2009 |
| Last Update Date | 02/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326287426 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 017107 (New York) | Primary |
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