Basic Information
| Provider Information | |||||||||
| NPI: | 1144621418 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POGGE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | LLOYD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 CROSS RIVER RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105363549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147638151 | ||||||||
| FaxNumber: | 9147633345 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 CROSS RIVER RD | ||||||||
| Address2: | |||||||||
| City: | KATONAH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105363549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9147638151 | ||||||||
| FaxNumber: | 9147633345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2014 | ||||||||
| LastUpdateDate: | 09/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | 9006 | NY | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103TC0700X | 9006 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.