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General NPI Number Information
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NPI Number | 1841500808
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Entity Type | Individual
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Provider Name | DENISE M. TRACEY M.S. ED.
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Gender | Female
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/08/2010
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Provider Practice Location Address
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Address Line | 60 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10010-1600
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Country | US
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Telephone | 866-696-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 17 GREENRIDGE WAY
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City | SPRING VALLEY
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State | NY
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Zip | 10977-1814
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Country | US
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Telephone | 914-843-3719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1863289
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License Number State | NY
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