Healthcare Provider Details

I. General information

NPI: 1114210986
Provider Name (Legal Business Name): NORKA TRUDY MALBERG PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 08/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 JAMES ST STE 202
NEW HAVEN CT
06513-3090
US

IV. Provider business mailing address

1886 LITCHFIELD TPKE
WOODBRIDGE CT
06525-2315
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-8648
  • Fax:
Mailing address:
  • Phone: 203-298-4875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number002074
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: