Provider Demographics
NPI:1568658938
Name:BISK, LAUREN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:BISK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 BROADWAY
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2800
Mailing Address - Country:US
Mailing Address - Phone:212-420-0001
Mailing Address - Fax:212-799-9327
Practice Address - Street 1:2373 BROADWAY
Practice Address - Street 2:SUITE 1030
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2800
Practice Address - Country:US
Practice Address - Phone:212-420-0001
Practice Address - Fax:212-799-9327
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014300-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist