Provider Demographics
NPI:1174764120
Name:CUYJET, VALERIE (NP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:CUYJET
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2805
Mailing Address - Street 2:8 SOUND VIEW DRIVE
Mailing Address - City:SAG HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11963-0121
Mailing Address - Country:US
Mailing Address - Phone:631-725-4147
Mailing Address - Fax:
Practice Address - Street 1:1919 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2745
Practice Address - Country:US
Practice Address - Phone:212-987-1777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-420467363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP16995Medicare UPIN