Basic Information
| Provider Information | |||||||||
| NPI: | 1508044462 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEPHEN P TROISE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8369 LANGDON ST | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191521701 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2250 HICKORY RD | ||||||||
| Address2: | 240 | ||||||||
| City: | PLYMOUTH MEETING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194621047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108341122 | ||||||||
| FaxNumber: | 6108347525 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2008 | ||||||||
| LastUpdateDate: | 02/03/2008 | ||||||||
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| AuthorizedOfficialLastName: | TROISE | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | PATRICK | ||||||||
| AuthorizedOfficialTitleorPosition: | RN | ||||||||
| AuthorizedOfficialTelephone: | 2152394819 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | 502566 | PA | Y | Agencies | Nursing Care |
ID Information
| ID | Type | State | Issuer | Description | 502566 | 01 | PA | RN NUMBER | OTHER |