Healthcare Provider Details
I. General information
NPI: 1427532886
Provider Name (Legal Business Name): PYAU LUKAS HUNG PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/21/2018
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
71 BROADWAY
DOBBS FERRY NY
10522-2834
US
IV. Provider business mailing address
1775 BALDWIN RD
YORKTOWN HEIGHTS NY
10598-5622
US
V. Phone/Fax
- Phone: 914-693-3030
- Fax:
- Phone: 914-962-2581
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 018504 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: