Provider Demographics
NPI:1255665287
Name:TRIOLO, JOSEPHINE (MS)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:TRIOLO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 DUFFY LN
Mailing Address - Street 2:
Mailing Address - City:GREENLAWN
Mailing Address - State:NY
Mailing Address - Zip Code:11740-2734
Mailing Address - Country:US
Mailing Address - Phone:631-261-0479
Mailing Address - Fax:
Practice Address - Street 1:8 DUFFY LN
Practice Address - Street 2:
Practice Address - City:GREENLAWN
Practice Address - State:NY
Practice Address - Zip Code:11740-2734
Practice Address - Country:US
Practice Address - Phone:631-261-0479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010564-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics