Healthcare Provider Details
I. General information
NPI: 1083063804
Provider Name (Legal Business Name): JUDITH C CURCIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 CORPORATE DR LEXINGTON CENTER FOR RECOVERY
PEEKSKILL NY
10566-1846
US
IV. Provider business mailing address
3 CORPORATE DR LEXINGTON CENTER FOR RECOVERY
PEEKSKILL NY
10566-1846
US
V. Phone/Fax
- Phone: 914-257-3500
- Fax:
- Phone: 914-257-3500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: