Tina M Trudel, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

882 Issued in NH

Practice address

1 Washington St
Suite 443
Dover, NH 03820-3848

Phone

(603) 493-4946

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Evaluation Specialists

  • Physical Therapy Clinic/Center
  • Portland, ME
  • NPI 1073941464
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1831248251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST",
            "address_2": "SUITE 443",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203848",
            "telephone_number": "603-493-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST",
            "address_2": "SUITE 443",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038203848",
            "telephone_number": "603-493-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEL",
        "first_name": "TINA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30420725",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "562384253",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2198542",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Tracey, LMT
• Denise Marie Trafton, COTA
• Abigail J Trnovsky, LISCW
• Nicholas P Trochalakis, PA-C
• Lisa Trott
• Austin Tucker, CCC-SLP
• John Wayne Tucker, D.D.S.
• Sandra J Tucker
• Tufts Counseling, PLLC.
• Paul C Tung, MD

• Clinical Neuropsychologist in Dover, NH
• Providers in Dover, NH by specialty
• Clinical Neuropsychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.