Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 62583 | CT |
Y | 207YP0228X | Pediatric Otolaryngology | 62583 | CT |
NPI | 1053754218 |
---|---|
Provider Name | Dr. Kiley Edward Trott |
First Address | Philadelphia, PA 19107-4216 |
Second Address | New Haven, CT 06504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 10/04/2019 |