Provider Demographics
NPI:1184835076
Name:LUCK, DANA ZARET (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:ZARET
Last Name:LUCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 SOUTH BROADWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4432
Mailing Address - Country:US
Mailing Address - Phone:914-997-5151
Mailing Address - Fax:914-997-0333
Practice Address - Street 1:34 SOUTH BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4432
Practice Address - Country:US
Practice Address - Phone:914-997-5151
Practice Address - Fax:914-997-0333
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0082361103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V64761Medicare ID - Type Unspecified