Provider Demographics
NPI:1689304313
Name:CAUSHAJ, LAURETA
Entity Type:Individual
Prefix:
First Name:LAURETA
Middle Name:
Last Name:CAUSHAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 42ND ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2760
Mailing Address - Country:US
Mailing Address - Phone:347-320-0855
Mailing Address - Fax:
Practice Address - Street 1:4108 42ND ST APT 2B
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-2760
Practice Address - Country:US
Practice Address - Phone:347-320-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst