Provider Demographics
NPI:1356797815
Name:TROTTIER, DANA GEORGE (MA, LCAT, RDT)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:GEORGE
Last Name:TROTTIER
Suffix:
Gender:M
Credentials:MA, LCAT, RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 W 136TH ST
Mailing Address - Street 2:APT 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-7908
Mailing Address - Country:US
Mailing Address - Phone:917-921-9075
Mailing Address - Fax:
Practice Address - Street 1:504 W 136TH ST
Practice Address - Street 2:APT 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7908
Practice Address - Country:US
Practice Address - Phone:917-921-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001822221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist