Provider Demographics
NPI:1922346873
Name:TRAGER, CRISTEN (MS)
Entity Type:Individual
Prefix:MRS
First Name:CRISTEN
Middle Name:
Last Name:TRAGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:CRISTEN
Other - Middle Name:
Other - Last Name:SCUEREB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:71 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3123
Mailing Address - Country:US
Mailing Address - Phone:516-523-9441
Mailing Address - Fax:
Practice Address - Street 1:71 W OAK ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3123
Practice Address - Country:US
Practice Address - Phone:516-523-9441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1116864103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst