Healthcare Provider Details

I. General information

NPI: 1285350033
Provider Name (Legal Business Name): DAVID A DOBKOWSKI PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 UNION ST
SCHENECTADY NY
12309-6341
US

IV. Provider business mailing address

679 SALVIA LN
SCHENECTADY NY
12303-5148
US

V. Phone/Fax

Practice location:
  • Phone: 518-859-4015
  • Fax:
Mailing address:
  • Phone: 518-859-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000867-01
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: