National Provider Identifier

Jeffrey Mark Lackner, PSY.D.

Jeffrey Mark Lackner, PSY.D. is listed in the NPPES registry with a primary specialty of Cognitive & Behavioral Psychologist in Buffalo, NY and a listed phone number of (716) 898-5671.

NPI 1821293168Buffalo, NYCognitive & Behavioral Psychologist

Profile Overview

NPI
1821293168
Provider Type
Individual
Primary Specialty
Cognitive & Behavioral Psychologist
Enumeration Date
June 18, 2007
Last Updated
July 08, 2007

Practice Location

  • 462 Grider St
  • Room G208
  • Buffalo, NY 14215-3021

Phone: (716) 898-5671

Mailing Address

  • PO Box 93
  • Amherst, NY 14226-0093

Specialties

  • Cognitive & Behavioral Psychologist (103TB0200X)
Full Record
NPI
1821293168
Entity Type
Individual
Last Name
Lackner
First Name
Jeffrey
Middle Name
Mark
Credential
PSY.D.
Mailing Street Address
PO Box 93
Mailing City
Amherst
Mailing State
NY
Mailing ZIP Code
14226-0093
Mailing Country
US
Mailing Phone
(716) 898-5671
Mailing Fax
(716) 898-3040
Practice Street Address
462 Grider St
Practice Address Line 2
Room G208
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14215-3021
Practice Country
US
Practice Phone
(716) 898-5671
Practice Fax
(716) 898-3040
Enumeration Date
June 18, 2007
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Cognitive & Behavioral Psychologist (103TB0200X)
Other Identifiers
00025302101 (NY, Univera), DF1724 (NY, Rr Medicare), 000523299002 (NY, Blue Cross), 6108856 (NY, Iha)