Provider Demographics
NPI:1346512936
Name:TRUJILLO, DANIEL AMADO (PHD)
Entity Type:Individual
Prefix:PROF
First Name:DANIEL
Middle Name:AMADO
Last Name:TRUJILLO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:50 HAVEN AVE
Mailing Address - Street 2:102
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2652
Mailing Address - Country:US
Mailing Address - Phone:212-305-3989
Mailing Address - Fax:212-342-3955
Practice Address - Street 1:50 HAVEN AVE
Practice Address - Street 2:102
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2652
Practice Address - Country:US
Practice Address - Phone:212-305-3989
Practice Address - Fax:212-342-3955
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)