Healthcare Provider Details

I. General information

NPI: 1942360011
Provider Name (Legal Business Name): HOWARD TRACHTMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E 30TH ST
NEW YORK NY
10016-8203
US

IV. Provider business mailing address

227 E 30TH ST
NEW YORK NY
10016-8203
US

V. Phone/Fax

Practice location:
  • Phone: 646-501-2663
  • Fax: 212-263-4053
Mailing address:
  • Phone: 646-501-2663
  • Fax: 212-263-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number147664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: