Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dmitri Bougakov PHD Psychology PLLC

Organization Clinical Neuropsychologist · NPI 1326287426

Dmitri Bougakov PHD Psychology PLLC is a Clinical Neuropsychologist in New York, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

315 W 57th St Ste 401
New York, NY 10019-3158
Phone: (212) 541-6412
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 017107 (NY)

Record details

NPI number1326287426
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Dmitri Bougakov — Sole Proprietor · (646) 496-8963
NPI enumeratedFebruary 12, 2009
Last updated in NPPESFebruary 12, 2009
Mailing address340 E Mosholu Pkwy S, Apartment 6g, Bronx, NY 10458-1742

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