DR. Russell Keith Bomse, PH.D.

NPI #1780725705 in Northport, New York

Provider Information

NPI Number
1780725705
Entity Type
Individual
Name
DR. Russell Keith Bomse, PH.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Psychologist - Clinical
Credential
PH.D.
Enumeration Date
Feb 11, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
90 MAR KAN DR
ZIP Code
11768-1858
Phone
(631) 754-6192

Specialties & Taxonomy Codes

Specialty
Psychologist - ClinicalClinical

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