Healthcare Provider Details

I. General information

NPI: 1073607073
Provider Name (Legal Business Name): VERONICA MARIA LUGRIS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 EAST 12TH ST SUITE 2A-F
NEW YORK NY
10003-4566
US

IV. Provider business mailing address

24 EAST 12TH ST SUITE 2A-F
NEW YORK NY
10003-4566
US

V. Phone/Fax

Practice location:
  • Phone: 212-252-6802
  • Fax:
Mailing address:
  • Phone: 212-252-6802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number015548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: