Provider Demographics
NPI:1730279910
Name:LASKY, JUDITH FAYE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:FAYE
Last Name:LASKY
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 1:257 CENTRAL PARK WEST
Mailing Address - Street 2:APT. 5A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4108
Mailing Address - Country:US
Mailing Address - Phone:212-595-4352
Mailing Address - Fax:212-579-1733
Practice Address - Street 1:257 CENTRAL PARK WEST
Practice Address - Street 2:APT. 5A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4108
Practice Address - Country:US
Practice Address - Phone:212-595-4352
Practice Address - Fax:212-579-1733
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004463103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist