Provider Demographics
NPI:1093883373
Name:PICKUS, LYNN (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:PICKUS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HOLLYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3701
Mailing Address - Country:US
Mailing Address - Phone:516-242-1497
Mailing Address - Fax:
Practice Address - Street 1:376 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3508
Practice Address - Country:US
Practice Address - Phone:516-932-1952
Practice Address - Fax:516-932-7693
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15493103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist