DR. BARBARA BRADLEY BOLEN (NPI# 1750481446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750481446 |
| Entity Type | Individual |
| Full Name | DR. BARBARA BRADLEY BOLEN |
| Credential | PH.D. |
| Practice Address |
17 Conklin St 2nd Floor Farmingdale NY 11735-2557 |
| Mailing Address |
331 Scudder Ave Northport NY 11768-3020 |
| Practice Telephone | 5164546921 |
| Mailing Telephone | 5164546921 |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
009514-0 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01249889 | 05 |
| Street Address |
17 CONKLIN ST 2ND FLOOR |
| City | FARMINGDALE |
| State | NY |
| Zip Code | 11735-2557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285714022 | Mike M Kalogiannis | Dentist | 17 Conklin St, Suite 2, Farmingdale, NY 11735 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073151197 | Center Island Massage PC | Massage Therapist | 34 Hempstead Turnpike, Suite E, Farmingdale, NY 11735 | 2019-12-19 |
| 1447736434 | Melanie Clampitt | Occupational Therapy Assistant | 158 Sunset Ave, Farmingdale, NY 11735 | 2018-07-13 |
| 1841789120 | I-ting Lin | Acupuncturist | 376 Fulton St. The Phoenix Eastern Medicine Center, Farmingdale, NY 11735 | 2018-05-02 |
| 1447767371 | Nashon Clark | Social Worker | 565 Broadhollow Rd Ste 6e, Farmingdale, NY 11735 | 2017-12-31 |
| 1336669639 | Robby Harris | Psychologist | 31 Lincoln Street, Farmingdale, NY 11735 | 2017-06-27 |
| 1265961544 | Stacey Gouzos | Behavior Technician | 29 Bernard Street, Farmingdale, NY 11735 | 2017-06-08 |
| 1962856450 | Integrated Medical Interventional Diagnostics PC | Registered Nurse | 1111 Broad Hollow Rd 110 Suite 114, Farmingdale, NY 11735 | 2016-04-20 |
| 1528433604 | Robert Gerard Jr. | Peer Specialist | 142-02 20th Aveune, Rosedale, NY 11735 | 2015-12-01 |
| 1750750329 | Glenda Lopez | Case Manager/Care Coordinator | 539 Broad Hollow Rd, Suite 202, Farmingdale, NY 11735 | 2015-09-24 |
| 1366849911 | Jeffrey Rosa | Counselor | 500 Bi-country Blvd, Suite 114, Farmingdale, NY 11735 | 2014-11-25 |
| Find all providers in zip 11735 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487215026 | Elizabeth R Mchugh | Psychologist | 1451 Nj 34, Farmingdale, NJ 07727 | 2019-06-25 |
| 1194883884 | Theresa Irene Desantis | Psychologist | 1111 Broadhollow Rd, Suite 204, Farmingdale, NY 11735-4820 | 2006-12-05 |
| 1922166628 | First Light Psychological Services, P.l.l.c. | Psychologist | 1111 Broadhollow Rd, Suite 204, Farmingdale, NY 11735-4820 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1184225849 | Linda L Street | Psychologist | 165 Saint Regis Dr, Massapequa Park, NY 11762-3454 | 2020-11-07 |
| 1063012318 | Inga Korsgaard | Psychologist | 233 Broadway Rm 850, New York, NY 10279-0800 | 2020-10-27 |
| 1194324657 | Elizabeth Brunoski | Psychologist | 50 W 67th St Ste 5h, New York, NY 10023-6227 | 2020-10-25 |
| 1760081830 | Meagan Ryan | Psychologist | 1 3rd Ave Apt 516, Mineola, NY 11501-4340 | 2020-10-20 |
| 1912505587 | Elspeth Hayden Kelly | Psychologist | 519 8th Ave Fl 8, New York, NY 10018-6506 | 2020-10-15 |
| 1700484623 | Rena Lee Miller | Psychologist | 252 N 6th St Apt 17, Brooklyn, NY 11211-3367 | 2020-10-13 |
| 1558968842 | Ethan Eisen | Psychologist | 107 Lakeside Dr E, Lawrence, NY 11559-1718 | 2020-10-08 |
| 1790382398 | Katelynn Marie Faulkner | Psychologist | 1 Old Plank Rd # 1d, Clinton, NY 13323-1802 | 2020-10-06 |
| 1811594039 | Pinchus Feintuch | Psychologist | 1580 E 18th St Ste 101, Brooklyn, NY 11230-7261 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGDALE |
| Zip Code | 11735 |
Please comment or provide details below to improve the information on DR. BARBARA BRADLEY BOLEN.
| 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.