MEDICARE: DR. BINA ROGINSKY PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2991	CT
2	103K00000X	Behavior Analyst	1-14-15426	CT
3	103TC2200X	Clinical Child & Adolescent Psychologist
4	103TB0200X	Cognitive & Behavioral Psychologist
5	103TF0200X	Forensic Psychologist
6	103TM1800X	Intellectual & Developmental Disabilities Psychologist

General Provider Information

NPI Number	:	1235269721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BINA ROGINSKY PSY.D.

Provider Business Mailing Address
First Line	:	21 HAZEL TER
Second Line	:	SUITE B
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-2209
Country	:	US
Telephone Number	:	203-848-7590
Fax Number	:	203-285-6455

Provider Business Practice Location Address
First Line	:	21 HAZEL TER
Second Line	:	SUITE B
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-2209
Country	:	US
Telephone Number	:	203-848-7590
Fax Number	:	203-285-6455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	02/13/2015

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