Provider Demographics
NPI:1891820940
Name:TRAGER, NORMAN (MA)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:
Last Name:TRAGER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-0634
Mailing Address - Country:US
Mailing Address - Phone:845-353-9834
Mailing Address - Fax:845-534-4712
Practice Address - Street 1:310 N BROADWAY
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-1643
Practice Address - Country:US
Practice Address - Phone:845-353-9834
Practice Address - Fax:845-534-4712
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002395101YM0800X
MI68010634031041C0700X
NY000409106H00000X
CT000138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist