Individual
DR. JONATHAN DAVID KURT TRAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 MIDDLE NECK RD, SUITE #5, GREAT NECK, NY 11021-1126
(516) 482-5400
(516) 482-5401
Mailing address
32 BERKSHIRE RD, GREAT NECK, NY 11023-2131
(516) 466-6649
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
200519
NY
207NP0225X
Pediatric Dermatology Physician
200519
NY
208000000X
Pediatrics Physician
200519
NY
2080A0000X
Pediatric Adolescent Medicine Physician
200519-1
NY
Other
Enumeration date
03/10/2006
Last updated
12/21/2007
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