Provider Demographics
NPI:1053476754
Name:TRAUB, HOWARD LEE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:LEE
Last Name:TRAUB
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MINEOLA AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2023
Mailing Address - Country:US
Mailing Address - Phone:917-371-1504
Mailing Address - Fax:
Practice Address - Street 1:125 MINEOLA AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2023
Practice Address - Country:US
Practice Address - Phone:917-371-1504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015751103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical