Bhcofwny

Organization Active NPI Clinical Psychologist · Hamburg, NY

NPI 1689393191 · NPPES record last updated Aug 26, 2022

Key facts

NPI
1689393191
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Psychologist 103TC0700X
Legal business name
BHCOFWNY
Practice address
5178 Parker Rd
Hamburg, NY 14075-1633
Phone
(716) 598-8827
NPI assigned
Aug 26, 2022
Organization subpart
No

Authorized official

Name
Dr. Charles Jack, PHD
Title
Owner/Sole Proprietor
Phone
(716) 598-8827

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC0700X Yes

Addresses

Primary practice location

5178 Parker Rd
Hamburg, NY 14075-1633

Mailing address

5178 Parker Rd
Hamburg, NY 14075-1633
Phone (716) 598-8827

Other names

  • BHCofWNY Doing business as

Other providers in Hamburg, NY

All providers in Hamburg, NY · Clinical Psychologist in New York

Sources for this page

Verify at the official NPI Registry.