Provider Demographics
NPI:1558670893
Name:TRACHTENBERG, NAOMI RUTH (RN, LCSW)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:RUTH
Last Name:TRACHTENBERG
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2936
Mailing Address - Country:US
Mailing Address - Phone:908-510-9534
Mailing Address - Fax:
Practice Address - Street 1:4 SCOTT DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2936
Practice Address - Country:US
Practice Address - Phone:908-510-9534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC014677001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical