Provider Demographics
NPI:1710022157
Name:PATRICIA TRAINOR, PHD, PSYCHOL PC
Entity Type:Organization
Organization Name:PATRICIA TRAINOR, PHD, PSYCHOL PC
Other - Org Name:AGING WELL CONSULTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAINOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-666-2827
Mailing Address - Street 1:101 HAWTHORN PL
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-2226
Mailing Address - Country:US
Mailing Address - Phone:914-666-2827
Mailing Address - Fax:914-666-2829
Practice Address - Street 1:101 S BEDFORD RD
Practice Address - Street 2:SUITE 202B
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3439
Practice Address - Country:US
Practice Address - Phone:914-666-2827
Practice Address - Fax:914-666-2829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012800103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02275730Medicaid
NY02275730Medicaid