Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist |
NPI | 1013001296 |
---|---|
Provider Name | Eugene Pogany |
First Address | Newton, MA 02461-2024 |
Second Address | Newton, MA 02461-2024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0512311 | (05) | MA |
707768 | TUFT (01) | |
W02962 | BC/BS (01) | MA |