Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD438036 | PA |
N | 111NI0900X | Internist | MD438036 | PA |
Y | 207RI0200X | Infectious Disease | MD438036 | PA |
NPI | 1073716296 |
---|---|
Provider Name | Stacey Trooskin |
First Address | Philadelphia, PA 19107-5400 |
Second Address | Philadelphia, PA 19107-5459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102707370 | (05) | PA |