DR. RUSSELL KEITH BOMSE (NPI# 1780725705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780725705 |
Entity Type | Individual |
Full Name | DR. RUSSELL KEITH BOMSE |
Credential | PH.D. |
Practice Address |
90 Mar Kan Dr Northport NY 11768-1858 |
Practice Telephone | 6317546192 |
Mailing Telephone | 6317546192 |
Enumeration Date | 2007-02-11 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
009117-1 | NY | Behavioral Health & Social Service Providers |
Street Address |
90 MAR KAN DR |
City | NORTHPORT |
State | NY |
Zip Code | 11768-1858 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649753088 | Tania Morris | Developmental Therapist | 130 Main St, #1, Northport, Ny 11768, Northport, NY 11768 | 2018-09-12 |
1639698343 | Karen Yuan Wong | Student in an Organized Health Care Education/Training Program | 79 Middleviille Rd., Optometry 123, Northport, NY 11768 | 2017-09-13 |
1821514795 | Village Speech and Language Pllc | Clinic/Center | 62 Makamah Beach Rd, Northport, NY 11768 | 2017-08-22 |
1073960415 | Dennis Falco | Private Vehicle | 5 Captain Richards Ln, Fort Salonga, NY 11768 | 2016-05-16 |
1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
1649649096 | Lillian Patricia Fais | Specialist | 26 Josephine Lane, Fort Salonga, NY 11768 | 2015-09-16 |
1427349505 | Kathleen Ann Korwasky | Occupational Therapist | 18 Dick Court, Northport, NY 11768 | 2011-04-25 |
1043448822 | Gianna Rose Ferranti | Dentist | 19 Winkle Point Road, Northport, NY 11768 | 2009-06-30 |
1861658213 | Barbara Ann Hansen | Registered Nurse | 78 Eatons Neck Rd, Northport, NY 11768 | 2008-08-05 |
1902060148 | Dana Ruth Cohen | Psychiatry & Neurology | 79 Middleville Road, Bldg 64, Northport Vamc, Northport, NY 11768 | 2008-07-16 |
Find all providers in zip 11768 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679938252 | Debra Marie Failla | Psychologist | 260 Main Street, Suite 202, Northport, NY 11768 | 2015-12-23 |
1730462060 | Ben F Mcmath IIi | Psychologist | 902 Main Ave, Ste G, Northport, AL 35476-4434 | 2011-09-22 |
1750587531 | John L. Ochoa | Psychologist | 41 Burr Ave, Northport, NY 11768-1926 | 2007-06-26 |
1598816068 | Sally Oakes Lauve | Psychologist | 302 Scudder Ave, Northport, NY 11768-2947 | 2007-01-12 |
1992891543 | George M Reisine | Psychologist | 299 Main Street, Northport, NY 11768 | 2006-10-04 |
1023104643 | Janet Ellen Eschen | Psychologist | Northport Vamc Psychology Service (116b), 79 Middleville Road, Northport, NY 11768 | 2006-10-04 |
1215960927 | Davis & Davis, Clinical Psychologists, PC | Psychologist | 3610 Watermelon Rd, Suite 105, Northport, AL 35473-5170 | 2006-07-08 |
1417958471 | David Wayne Gately | Psychologist | 79 Middleville Rd, Va Medical Center, Psychology Service (116b), Northport, NY 11768-2200 | 2005-08-02 |
1942600358 | Jennifer A. Sawaya | Psychologist | 79 Middleville Rd, Northport, NY 11768-2200 | 2014-09-04 |
1265869390 | Eftihia Linardatos | Psychologist | 79 Middleville Rd, Northport, NY 11768-2200 | 2013-10-03 |
Find all providers in NORTHPORT |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.