Healthcare Provider Details

I. General information

NPI: 1871244004
Provider Name (Legal Business Name): LYNN CUKAJ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 3RD AVE
NEW YORK NY
10017-3204
US

IV. Provider business mailing address

1 PARLEY LN
RIDGEFIELD CT
06877-4903
US

V. Phone/Fax

Practice location:
  • Phone: 646-450-3064
  • Fax: 855-930-2883
Mailing address:
  • Phone: 914-393-4625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number000104
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018635
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number010180
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: