Basic Information
| Provider Information | |||||||||
| NPI: | 1467004234 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUFF | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | STEVEN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1633 WASHINGTON BLVD APT 2F | ||||||||
| Address2: | |||||||||
| City: | STAMFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 069022424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034349132 | ||||||||
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| Practice Location | |||||||||
| Address1: | 606 E BALTIMORE PIKE | ||||||||
| Address2: | |||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190631751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108647376 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2019 | ||||||||
| LastUpdateDate: | 07/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 128 | CT | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.