1306812748 NPI number — MARLA TRIANO M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306812748 NPI number — MARLA TRIANO M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

TRIANO

Provider First Name:

MARLA

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

TRIANO-RODGERS

Provider Other First Name:

MARLA

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

MD

Provider Other Last Name Type Code:

1

NPI Number:

1306812748

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

2163 MEADOW RIDGE DR

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

LANCASTER

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17601-5762

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-669-0629

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

2500 BERNVILLE RD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

READING

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

19605-9453

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

610-378-2000

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

02/26/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2080N0001X , with the licence number:  MD044773L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 0015316080004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0812089000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 50056079 . This is a "CBC / KHPC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 000000132165 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1505565 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 3379363 . This is a "AETNA - HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 7894082 . This is a "AETNA - NONHMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0812089000 . This is a "AMERIHEALTH 65" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 20012093 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 000787162 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 30007498 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 37888 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".