1922090661 NPI number — MS. JUSTINE TROIA CRNA

Table of content: MS. JUSTINE TROIA CRNA (NPI 1922090661)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922090661 NPI number — MS. JUSTINE TROIA CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TROIA
Provider First Name:
JUSTINE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YAJKO
Provider Other First Name:
JUSTINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922090661
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
43 KENSICO DR
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-1009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-666-8866
Provider Business Mailing Address Fax Number:
914-666-6777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
160 N MIDLAND AVE
Provider Second Line Business Practice Location Address:
NYACK HOSPITAL
Provider Business Practice Location Address City Name:
NYACK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10960-1912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-348-2862
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2005

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: 367500000X , with the licence number:  427542 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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