Provider Demographics
NPI:1932263373
Name:CUMISKY, BETH ANNE (LICENSED MASTER SOCI)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANNE
Last Name:CUMISKY
Suffix:
Gender:F
Credentials:LICENSED MASTER SOCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 S. BROADWAY
Mailing Address - Street 2:1ST FL.
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705
Mailing Address - Country:US
Mailing Address - Phone:914-965-1751
Mailing Address - Fax:914-476-2421
Practice Address - Street 1:317 S. BROADWAY
Practice Address - Street 2:1ST FL.
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705
Practice Address - Country:US
Practice Address - Phone:914-965-1751
Practice Address - Fax:914-476-2421
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355940Medicaid
NY1285628552OtherAGENCY NPI
NYWVE061Medicare ID - Type UnspecifiedAGENCY MEDICARE PROVIDER#