Basic Information
Provider Information
NPI: 1932780228
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TROKHIMENKO
FirstName: ALLA
MiddleName:  
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NameSuffix:  
Credential: FNP-C
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Mailing Information
Address1: 5305 MILL RD
Address2:  
City: BROADVIEW HTS
State: OH
PostalCode: 441472219
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7007 POWERS BLVD
Address2:  
City: PARMA
State: OH
PostalCode: 441295437
CountryCode: US
TelephoneNumber: 4407433000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/18/2021
LastUpdateDate: 04/18/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 04/18/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAPRN.CNP.0027987OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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