1124000112 NPI number — VICTORIA TRIOLA DO

Table of content: VICTORIA TRIOLA DO (NPI 1124000112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124000112 NPI number — VICTORIA TRIOLA DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRIOLA
Provider First Name:
VICTORIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

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:
1124000112
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED BANK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-460-9840
Provider Business Mailing Address Fax Number:
732-460-9848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
370 HIGHWAY 35
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
RED BANK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-758-0048
Provider Business Practice Location Address Fax Number:
732-758-0052
Provider Enumeration Date:
11/16/2005

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: 207Q00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2676116 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2135760 . This is a "OXFORD HEALTH PLANS NJ" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25V491 . This is a "EMPIRE BCBS OF NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8485003 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1K6902 . This is a "HEALTH NET OF NEW JERSEY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2153614 . This is a "UNITED HEALTHCARE OF NJ" identifier . This identifiers is of the category "OTHER".




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