Healthcare Provider Details

I. General information

NPI: 1831177609
Provider Name (Legal Business Name): NEIL GEOFFREY TRACHTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 03/24/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 ROWLAND ST SUITE 217
BALLSTON SPA NY
12020
US

IV. Provider business mailing address

71 ROWLAND ST SUITE 217
BALLSTON SPA NY
12020
US

V. Phone/Fax

Practice location:
  • Phone: 518-288-3240
  • Fax: 518-288-3240
Mailing address:
  • Phone: 518-288-3240
  • Fax: 518-288-3240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number143371
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number143371
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: