Provider Demographics
NPI:1033285127
Name:TROTZKY, SAMUEL W (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:W
Last Name:TROTZKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 BORTHWICK AVE
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7128
Mailing Address - Country:US
Mailing Address - Phone:603-433-4012
Mailing Address - Fax:603-433-5184
Practice Address - Street 1:333 BORTHWICK AVE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7128
Practice Address - Country:US
Practice Address - Phone:603-433-4012
Practice Address - Fax:603-433-5184
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10847207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH01Y002331NH02OtherANTHEM
ME258580099Medicaid
MA0112780Medicaid
NHAA137936OtherHARVARD PILGRIM (SEACOAST)
930098183OtherRAILROAD MEDICARE
AA79577OtherHARVARD PILGRIM
NHP00697977OtherRAILROAD MEDICARE - SEACOAST
NH1033285127OtherANTHEM BCBS NH
NH30200706Medicaid
NHAA203136OtherHARVARD
AA79577OtherHARVARD PILGRIM
NHAA137936OtherHARVARD PILGRIM (SEACOAST)
NH30200706Medicaid
NHRE581101Medicare PIN