Provider Demographics
NPI:1144532615
Name:TROISO, SUSAN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:TROISO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HARVARD LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2527
Mailing Address - Country:US
Mailing Address - Phone:631-258-8394
Mailing Address - Fax:631-486-2415
Practice Address - Street 1:45 HARVARD LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2527
Practice Address - Country:US
Practice Address - Phone:631-258-8394
Practice Address - Fax:631-486-2415
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist