Provider Demographics
NPI:1871255505
Name:LAY, JUNE M (MS)
Entity Type:Individual
Prefix:MS
First Name:JUNE
Middle Name:M
Last Name:LAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 60TH ST APT 9P
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1586
Mailing Address - Country:US
Mailing Address - Phone:646-559-1637
Mailing Address - Fax:
Practice Address - Street 1:401 E 60TH ST APT 9P
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1586
Practice Address - Country:US
Practice Address - Phone:646-559-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No133N00000XDietary & Nutritional Service ProvidersNutritionist