Provider Demographics
NPI:1316117989
Name:BG CENTER
Entity type:Organization
Organization Name:BG CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GINDIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-694-9496
Mailing Address - Street 1:150 AIRPORT EXECUTIVE PARK
Mailing Address - Street 2:SUITE 152
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954
Mailing Address - Country:US
Mailing Address - Phone:845-694-8496
Mailing Address - Fax:845-694-8497
Practice Address - Street 1:150 AIRPORT EXECUTIVE PARK
Practice Address - Street 2:SUITE 152
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954
Practice Address - Country:US
Practice Address - Phone:845-694-8496
Practice Address - Fax:845-694-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010141103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty