Provider Demographics
NPI:1871244004
Name:CUKAJ, LYNN
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CUKAJ
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 1:20 BLACKBERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3175
Mailing Address - Country:US
Mailing Address - Phone:914-393-4625
Mailing Address - Fax:
Practice Address - Street 1:115 E 23RD ST # 1513
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4508
Practice Address - Country:US
Practice Address - Phone:646-450-3064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health