1093894222 NPI number — DR. TERENCE A TRINKA I O.D. CN

Table of content: DR. TERENCE A TRINKA I O.D. CN (NPI 1093894222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093894222 NPI number — DR. TERENCE A TRINKA I O.D. CN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRINKA
Provider First Name:
TERENCE
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
I
Provider Credential Text:
O.D. CN
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:
1093894222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26689 PLEASANT PARK RD
Provider Second Line Business Mailing Address:
#150
Provider Business Mailing Address City Name:
CONIFER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80433-7703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-838-9355
Provider Business Mailing Address Fax Number:
303-838-9526

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26689 PLEASANT PARK RD
Provider Second Line Business Practice Location Address:
#150
Provider Business Practice Location Address City Name:
CONIFER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80433-7703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-838-9355
Provider Business Practice Location Address Fax Number:
303-838-9526
Provider Enumeration Date:
11/06/2006

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: 133N00000X , with the licence number:  000895 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: CO1157 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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