Provider Demographics
NPI:1538680533
Name:SHRAGGE, AARON (MA, MT-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:SHRAGGE
Suffix:
Gender:M
Credentials:MA, MT-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 E 3RD ST # 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2301
Mailing Address - Country:US
Mailing Address - Phone:917-902-7369
Mailing Address - Fax:
Practice Address - Street 1:239 EAST 3RD STREET
Practice Address - Street 2:#2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2301
Practice Address - Country:US
Practice Address - Phone:917-902-7369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002072-1225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist