1568998565 NPI number — ERIN ELIZABETH TROXELL PA-C

Table of content: ERIN ELIZABETH TROXELL PA-C (NPI 1568998565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568998565 NPI number — ERIN ELIZABETH TROXELL PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TROXELL
Provider First Name:
ERIN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAGER
Provider Other First Name:
ERIN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568998565
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 SOUTH FRONT STREET
Provider Second Line Business Mailing Address:
4TH FLOOR, BMA
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-231-8555
Provider Business Mailing Address Fax Number:
717-231-8568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 SOUTH FRONT STREET
Provider Second Line Business Practice Location Address:
4TH FLOOR, BMA
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17104-1619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-231-8555
Provider Business Practice Location Address Fax Number:
717-231-8568
Provider Enumeration Date:
05/11/2017

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: 363AM0700X , with the licence number:  MA059030 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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