DR. GEORGE JAMES BOUKLAS PH.D NPI 1891834305

NPI Information

  • NPI: 1891834305
  • Provider Name: DR. GEORGE JAMES BOUKLAS, PH.D
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 69A GNARLED HOLLOW RD
    EAST SETAUKET, NY
    ZIP 11733
  • Phone: (631) 751-0092

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NPI Details

DR. George James Bouklas, PH.D is a clinical psychologist in East Setauket, NY. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. George James Bouklas, PH.D NPI is 1891834305. 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:

69A GNARLED HOLLOW RD
EAST SETAUKET, NY
ZIP 11733-026
Phone: (631) 751-0092
Fax: (631) 689-6201

The enumeration date for this NPI number is 2/5/2007 and was last updated on 7/8/2007.

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
1103TC0700XPsychologistClinical011248NEW 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
1V5B791MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
201338949MEDICAIDNEW 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

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