DMITRI BOUGAKOV PH.D. NPI 1851414031

NPI Information

  • NPI: 1851414031
  • Provider Name: DMITRI BOUGAKOV, PH.D.
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • Address: 315 W 57TH ST
    SUITE 401
    NEW YORK, NY
    ZIP 10019
  • Phone: (646) 496-8963

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NPI Details

Dmitri Bougakov, PH.D. is a clinical neuropsychologist in New York, NY. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Dmitri Bougakov, PH.D. NPI is 1851414031. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

315 W 57TH ST
SUITE 401
NEW YORK, NY
ZIP 10019-158
Phone: (646) 496-8963

The enumeration date for this NPI number is 4/10/2007 and was last updated on 11/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist68 017107NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102969217MEDICAIDNEW YORK
2VN4541MEDICARE PINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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