MEDICARE: DANA GEORGE TROTTIER MA, LCAT, RDT

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
1	221700000X	Art Therapist	001822	NY

General Provider Information

NPI Number	:	1356797815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA GEORGE TROTTIER MA, LCAT, RDT

Provider Business Mailing Address
First Line	:	504 W 136TH ST
Second Line	:	APT 3A
City	:	NEW YORK
State	:	NY
Zip	:	10031-7908
Country	:	US
Telephone Number	:	917-921-9075
Fax Number	:

Provider Business Practice Location Address
First Line	:	504 W 136TH ST
Second Line	:	APT 3A
City	:	NEW YORK
State	:	NY
Zip	:	10031-7908
Country	:	US
Telephone Number	:	917-921-9075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2016
Last Update Date	:	05/13/2016

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