Healthcare Provider Details

I. General information

NPI: 1568243962
Provider Name (Legal Business Name): SEKINAT MOJOYIN KUKU PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 6TH AVE FL 8
NEW YORK NY
10013-1905
US

IV. Provider business mailing address

55 ARLINGTON AVE APT 311
BLOOMFIELD NJ
07003-4687
US

V. Phone/Fax

Practice location:
  • Phone: 917-451-6470
  • Fax:
Mailing address:
  • Phone: 973-342-0708
  • Fax: 973-342-0708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: