Healthcare Provider Details

I. General information

NPI: 1821302787
Provider Name (Legal Business Name): LYNN SESKIN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 08/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5110 12TH AVE
BROOKLYN NY
11219-3424
US

IV. Provider business mailing address

5110 12TH AVE
BROOKLYN NY
11219-3424
US

V. Phone/Fax

Practice location:
  • Phone: 800-275-3243
  • Fax: 718-854-8308
Mailing address:
  • Phone: 800-275-3243
  • Fax: 718-854-8308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number018387-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: