Healthcare Provider Details

I. General information

NPI: 1528126281
Provider Name (Legal Business Name): BERNARD CHARLES WOYCHOWSKI PHD CLINICAL PSYCHOL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 PURCHASE STREET
RYE NY
10580
US

IV. Provider business mailing address

40 WINDSOR ROAD
RYE BROOK NY
10573
US

V. Phone/Fax

Practice location:
  • Phone: 914-937-2842
  • Fax: 914-939-2533
Mailing address:
  • Phone: 914-937-2842
  • Fax: 914-939-2533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0111401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: