Provider Demographics
NPI:1487717617
Name:BUCATINSKY, MYRIAM (LCSW)
Entity type:Individual
Prefix:MS
First Name:MYRIAM
Middle Name:
Last Name:BUCATINSKY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:FUHRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 PIERREPONT STREET
Mailing Address - Street 2:#3B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2771
Mailing Address - Country:US
Mailing Address - Phone:718-852-8208
Mailing Address - Fax:718-488-1999
Practice Address - Street 1:123 PIERREPONT STREET
Practice Address - Street 2:#3B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2771
Practice Address - Country:US
Practice Address - Phone:718-852-8208
Practice Address - Fax:718-488-1999
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR02233511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N0A551Medicare ID - Type Unspecified