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NPI Code Detail

MEDICARE: AMY B TRACHTER PSY.D.,PH.D.

MEDICARE: AMY B TRACHTER PSY.D.,PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist015934NY
2103TC0700XClinical PsychologistPY6540FL

General Provider Information

NPI Number : 1184892986
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY B TRACHTER PSY.D.,PH.D.
Provider Business Mailing Address
First Line : 57B SAGAMORE HILL DR
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-2038
Country : US
Telephone Number : 516-849-3925
Fax Number :
Provider Business Practice Location Address
First Line : 324 E 23RD ST
Second Line :
City : NEW YORK
State : NY
Zip : 10010-4701
Country : US
Telephone Number : 516-849-3925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2008
Last Update Date : 02/14/2008

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