Provider Demographics
NPI:1235290008
Name:NANCY M TROAST DO PA
Entity Type:Organization
Organization Name:NANCY M TROAST DO PA
Other - Org Name:TROAST AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TROAST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-278-0400
Mailing Address - Street 1:7841 CAMBRIDGE MANOR PL STE A
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-4635
Mailing Address - Country:US
Mailing Address - Phone:239-278-0400
Mailing Address - Fax:239-278-0399
Practice Address - Street 1:7841 CAMBRIDGE MANOR PL STE A
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-4635
Practice Address - Country:US
Practice Address - Phone:239-278-0400
Practice Address - Fax:239-278-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255061000Medicaid
FLCN9577OtherRAILROAD MEDICARE
FL39692Medicare PIN
FLCN9577OtherRAILROAD MEDICARE