JEFFREY MARK LACKNER (NPI# 1821293168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821293168 |
| Entity Type | Individual |
| Full Name | JEFFREY MARK LACKNER |
| Credential | PSY.D. |
| Practice Address |
462 Grider St Room G208 Buffalo NY 14215-3021 |
| Mailing Address |
Po Box 93 Amherst NY 14226-0093 |
| Practice Telephone | 7168985671 |
| Practice Fax Number | 7168983040 |
| Mailing Telephone | 7168985671 |
| Mailing Fax Number | 7168983040 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
012051 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | BLUE CROSS | 000523299002 | 01 |
| NY | RR MEDICARE | DF1724 | 01 |
| NY | UNIVERA | 00025302101 | 01 |
| NY | IHA | 6108856 | 01 |
| Street Address |
462 GRIDER ST ROOM G208 |
| City | BUFFALO |
| State | NY |
| Zip Code | 14215-3021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831195395 | Kara Anne Woods | Physician Assistant | 462 Grider St, Buffalo, NY 14215-3098 | 2005-06-21 |
| 1396355095 | Jenna Elizabeth Nassar | Hospitalist | 462 Grider St, Buffalo, NY 14215-3098 | 2020-08-06 |
| 1962010272 | Jannet Li Harkins | Registered Nurse | 462 Grider St, Buffalo, NY 14215-3021 | 2020-07-22 |
| 1831717172 | Toluwanimi Mercy Aladesua | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-07-13 |
| 1568088854 | Elizabeth Ifeyironwa Onyechi | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-06-22 |
| 1285257949 | Jianhua Wu | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-28 |
| 1710500277 | Calvin James Meaney | Pharmacist | 462 Grider St, Buffalo, NY 14215-3098 | 2020-05-19 |
| 1033731963 | Kaylyn Bunz | Counselor | 462 Grider St, Buffalo, NY 14215-3098 | 2020-05-14 |
| 1356963623 | Holly Renee Johnson | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-10 |
| 1023630522 | Kevin Michael Todd | Student in an Organized Health Care Education/Training Program | 462 Grider St, Buffalo, NY 14215-3021 | 2020-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497366413 | Krista Lea Marita Koskinen | Student in an Organized Health Care Education/Training Program | 462 Grider Street, 11th Floor, Erie County Medical Cent, Buffalo, NY 14215 | 2020-08-13 |
| 1851919112 | Temitope Oluwaseun Ajayi | Student in an Organized Health Care Education/Training Program | 132 Affinity Lane, Buffalo, NY 14215 | 2020-07-13 |
| 1134741986 | Alexandra Lucia Tibil | Student in an Organized Health Care Education/Training Program | 462 Grider Street, Erie County Medical Center David K., Buffalo, NY 14215 | 2020-05-15 |
| 1093336646 | Sanjeevani Tomar | Student in an Organized Health Care Education/Training Program | University At Buffalo-suny, Department of Medicine, 462 Grider Street, Buffalo, NY 14215 | 2020-05-05 |
| 1982225926 | Rohan Pandey | Student in an Organized Health Care Education/Training Program | 462 Grider St. Erie County Medical Center, Buffalo, NY 14215 | 2020-04-30 |
| 1235759911 | Michael William O'donnell | Student in an Organized Health Care Education/Training Program | Erie County Medical Center Dk Miller Building, 462 Grider Street, Buffalo, NY 14215 | 2020-04-22 |
| 1780204883 | Ishwor Sharma | Student in an Organized Health Care Education/Training Program | Ecmc 462, Grider Street, Dk Miller Bldg, First Floor, Room C100-b, Buffalo, NY 14215 | 2020-04-20 |
| 1174142632 | Salman Masood | Student in an Organized Health Care Education/Training Program | 462 Grider Street Buffalo, Ny 14215, Buffalo, NY 14215 | 2020-04-14 |
| 1730718354 | Charles Feng Hua Zhang | Student in an Organized Health Care Education/Training Program | Erie County Medical Center, 462 Grider Street, Buffalo, NY 14215 | 2020-04-06 |
| 1700415650 | Joseph Charles L'huillier | Student in an Organized Health Care Education/Training Program | General Surgery Residency Program, Ecmc, Dk Miller Bdg, 462 Grider Street, Buffalo, NY 14215 | 2020-04-03 |
| Find all providers in zip 14215 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861434169 | Abiola Dipeolu | Psychologist | 409 Baldy, Buffalo, NY 14260-1000 | 2006-06-12 |
| 1669466017 | Susan I Alessi | Psychologist | 703 West Ferry St Apt A15, Buffalo, NY 14222-1635 | 2005-08-31 |
| 1790244762 | Nicole Stevens | Psychologist | 70 Jewett Pkwy, Buffalo, NY 14214-2322 | 2019-03-18 |
| 1013049279 | Academic Health Psychology Associates, P.C. | Psychologist | 462 Grider St, Room G208, Buffalo, NY 14215-3021 | 2007-03-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768916 | Shari Kohn | Psychologist | 20 Shadow Ln, Woodbury, NY 11797-2222 | 2020-10-18 |
| 1770180325 | Jonathan Rosen | Psychologist | 1760 2nd Ave Apt 18a, New York, NY 10128-5392 | 2020-10-07 |
| 1245837855 | Aunree J. Houston | Psychologist | 400 W 37th St Apt 10y, New York, NY 10018-5631 | 2020-10-06 |
| 1255944377 | Mindwell Center, LLP | Psychologist | 950 Danby Rd Ste 202f, Ithaca, NY 14850-5714 | 2020-08-28 |
| 1417575754 | Donato Vaccaro | Psychologist | 40 Deerfield Ave, Eastchester, NY 10709-3805 | 2020-07-13 |
| 1902432511 | Nancy Langdon | Psychologist | 410 Fort Salonga Rd, Northport, NY 11768-3046 | 2020-03-14 |
| 1386281376 | Grand Central Psychology Pllc | Psychologist | 50 E 42nd St Rm 1807, New York, NY 10017-5402 | 2019-12-09 |
| 1730722232 | Shimon N Littman | Psychologist | 495 W 187th St Apt 5e, New York, NY 10033-1521 | 2019-10-28 |
| 1821645367 | Rd Community Services LLC | Psychologist | 1049 38th St Ste B, Brooklyn, NY 11219-1012 | 2019-08-20 |
| 1881250041 | New Perspective Psychological Services | Psychologist | 1170a Ocean Ave, Brooklyn, NY 11230-1904 | 2019-05-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JEFFREY MARK LACKNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.