Lyko, Jessica

Lyko, Jessica is an individual health care provider with primary practice located at 123 Pike St , Port Jervis NY 12771-1824. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Lyko, Jessica can be contacted via phone (845) 856-7576.

Contact Information

Primary practice address
123 Pike St Port Jervis NY 12771-1824
Phone: (845) 856-7576
Fax: (845) 383-8010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 108127-01 New York
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1407256365
LBN Legal business name Lyko, Jessica
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2014
Last updated Jun 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407256365 NPPES
Pennsylvania MEDICAID 1007592970029

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