Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 210710 | NY |
N | 2081P2900X | Pain Medicine | 210710 | NY |
NPI | 1396725081 |
---|---|
Provider Name | Michael Trimba |
First Address | Brooklyn, NY 11229-3510 |
Second Address | Brooklyn, NY 11229-3510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 16/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01863881 | (05) | NY |
G73328 | (02) | NY |