Provider Demographics
NPI:1235596529
Name:DR. TRO'S MEDICAL WEIGHT LOSS & DIRECT PRIMARY CARE
Entity Type:Organization
Organization Name:DR. TRO'S MEDICAL WEIGHT LOSS & DIRECT PRIMARY CARE
Other - Org Name:PALISADESMD
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRO
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAYJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-397-2873
Mailing Address - Street 1:84 ROUTE 303
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2806
Mailing Address - Country:US
Mailing Address - Phone:845-397-2873
Mailing Address - Fax:
Practice Address - Street 1:84 ROUTE 303
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2806
Practice Address - Country:US
Practice Address - Phone:845-397-2873
Practice Address - Fax:888-674-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty