1033285127 NPI number — SAMUEL W TROTZKY MD

Table of content: SAMUEL W TROTZKY MD (NPI 1033285127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033285127 NPI number — SAMUEL W TROTZKY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TROTZKY
Provider First Name:
SAMUEL
Provider Middle Name:
W
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033285127
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
333 BORTHWICK AVE
Provider Second Line Business Mailing Address:
EMERGENCY DEPT
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03801-7128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-433-4012
Provider Business Mailing Address Fax Number:
603-433-5184

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
333 BORTHWICK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03801-7128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-433-4012
Provider Business Practice Location Address Fax Number:
603-433-5184
Provider Enumeration Date:
11/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  10847 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01Y002331NH02 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 258580099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0112780 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AA137936 . This is a "HARVARD PILGRIM (SEACOAST)" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 930098183 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA79577 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00697977 . This is a "RAILROAD MEDICARE - SEACOAST" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1033285127 . This is a "ANTHEM BCBS NH" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30200706 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: AA203136 . This is a "HARVARD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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