Provider Demographics
NPI:1447939400
Name:CYTRYN, LAURIE CYMERMAN (LMSW)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:CYMERMAN
Last Name:CYTRYN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 CORPORAL KENNEDY ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1442
Mailing Address - Country:US
Mailing Address - Phone:718-208-8505
Mailing Address - Fax:
Practice Address - Street 1:1875 CORPORAL KENNEDY ST APT 6E
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1442
Practice Address - Country:US
Practice Address - Phone:718-208-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24279104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker