Healthcare Provider Details

I. General information

NPI: 1326130220
Provider Name (Legal Business Name): CHRISTOPHER ROBERT BOWIE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W KINGSBRIDGE RD
BRONX NY
10468-3904
US

IV. Provider business mailing address

76 HAVILAND ROAD
CARMEL NY
10512-5864
US

V. Phone/Fax

Practice location:
  • Phone: 718-584-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number016712-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: