MEDICARE: DR. ANDREW AARON TRAUBEN MD

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	2084P0800X	Psychiatry Physician	186614	NY

General Provider Information

NPI Number	:	1831392216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW AARON TRAUBEN MD

Provider Business Mailing Address
First Line	:	200 EAST 94TH STREET
Second Line	:	# 1417
City	:	NEW YORK
State	:	NY
Zip	:	10128
Country	:	US
Telephone Number	:	212-861-8769
Fax Number	:	212-828-6802

Provider Business Practice Location Address
First Line	:	200 EAST 94TH STREET
Second Line	:	# 1417
City	:	NEW YORK
State	:	NY
Zip	:	10128
Country	:	US
Telephone Number	:	212-861-8769
Fax Number	:	212-828-6802

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

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	07/08/2007

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