Individual
BENNETT POLOGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5900 ARLINGTON AVE APT 7A, BRONX, NY 10471-1313
(917) 513-7196
(347) 202-7166
Mailing address
5900 ARLINGTON AVE APT 7A, BRONX, NY 10471-1313
(917) 513-7196
(347) 202-7166
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
10065-1
NY
103TC0700X
Clinical Psychologist
Primary
10065-1
NY
103TC2200X
Clinical Child & Adolescent Psychologist
10065-1
NY
103TF0200X
Forensic Psychologist
10065-1
NY
Other
Enumeration date
12/14/2006
Last updated
02/23/2021
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