Provider Demographics
NPI:1982786588
Name:TROTT, CHARLOTTE THORNHILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:THORNHILL
Last Name:TROTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-3029
Mailing Address - Country:US
Mailing Address - Phone:845-987-8639
Mailing Address - Fax:
Practice Address - Street 1:2048 OAK TREE RD
Practice Address - Street 2:CENTER FOR HEAD INJURIES; JFK-JOHNSON REHABILITATION
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2012
Practice Address - Country:US
Practice Address - Phone:732-906-2640
Practice Address - Fax:732-906-9241
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014427103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist