Provider Demographics
NPI:1568551117
Name:RONALD BOYKIN PSYCHOLOGIST PC
Entity Type:Organization
Organization Name:RONALD BOYKIN PSYCHOLOGIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:BOYKIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-426-8886
Mailing Address - Street 1:55 LENOX RD APT 1F
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5234
Mailing Address - Country:US
Mailing Address - Phone:516-426-8886
Mailing Address - Fax:
Practice Address - Street 1:55 LENOX RD APT 1F
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5234
Practice Address - Country:US
Practice Address - Phone:516-426-8886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009118103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV53661Medicare ID - Type UnspecifiedPROVIDER NUMBER