Provider Demographics
NPI:1356703797
Name:BATHORY INTERNATIONAL PLLC
Entity type:Organization
Organization Name:BATHORY INTERNATIONAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BATHORY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-444-1524
Mailing Address - Street 1:2575 WOODBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-4622
Mailing Address - Country:US
Mailing Address - Phone:908-444-1524
Mailing Address - Fax:
Practice Address - Street 1:2575 WOODBERRY DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-4622
Practice Address - Country:US
Practice Address - Phone:908-444-1524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2311103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty