Healthcare Provider Details

I. General information

NPI: 1477929271
Provider Name (Legal Business Name): MRS. LAUREN CUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2015
Last Update Date: 08/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 TOWER DR SUITE 400
MIDDLETOWN NY
10941-2056
US

IV. Provider business mailing address

192 TOWER DR SUITE 400
MIDDLETOWN NY
10941-2056
US

V. Phone/Fax

Practice location:
  • Phone: 845-692-4391
  • Fax:
Mailing address:
  • Phone: 845-692-4391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number1287808
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: