Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 26NJ01143300 | NJ |
NPI | 1093389488 |
---|---|
Provider Name | Renee Trotter |
First Address | Hoboken, NJ 07030-6305 |
Second Address | Bayonne, NJ 07002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2021 |
Last Update Date | 19/05/2021 |