Healthcare Provider Details

I. General information

NPI: 1992661276
Provider Name (Legal Business Name): VIKTOR DLUGUNOVYCH PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7346 192ND ST
FRESH MEADOWS NY
11366-1858
US

IV. Provider business mailing address

7346 192ND ST
FRESH MEADOWS NY
11366-1858
US

V. Phone/Fax

Practice location:
  • Phone: 347-733-3770
  • Fax:
Mailing address:
  • Phone: 347-733-3770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number027894
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: