Provider Demographics
NPI:1366509630
Name:CUKOR, JUDITH R (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:R
Last Name:CUKOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:RAPAPORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 E 68TH ST
Mailing Address - Street 2:BOX 200
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4870
Mailing Address - Country:US
Mailing Address - Phone:212-746-4492
Mailing Address - Fax:212-746-8552
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BOX 200
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-4492
Practice Address - Fax:212-746-8552
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015959-2103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS15959-0WOtherWORKERS' COMPENSATION
NYS15959-0WOtherWORKERS' COMPENSATION