Provider Demographics
NPI:1528126281
Name:WOYCHOWSKI, BERNARD CHARLES (PHD CLINICAL PSYCHOL)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:CHARLES
Last Name:WOYCHOWSKI
Suffix:
Gender:M
Credentials:PHD CLINICAL PSYCHOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WINDSOR ROAD
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573
Mailing Address - Country:US
Mailing Address - Phone:914-937-2842
Mailing Address - Fax:914-939-2533
Practice Address - Street 1:44 PURCHASE STREET
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580
Practice Address - Country:US
Practice Address - Phone:914-937-2842
Practice Address - Fax:914-939-2533
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0111401103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6802234OtherGHI
NY01695234Medicaid
0203329OtherCIGNA
206140OtherMHN
081808OtherVALUE OPTIONS
206140OtherMHN
02846NMedicare ID - Type Unspecified