Provider Demographics
NPI:1265483242
Name:TROST, JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:TROST
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 1:34 FAWN DR
Mailing Address - Street 2:
Mailing Address - City:QUARRYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17566-9741
Mailing Address - Country:US
Mailing Address - Phone:717-284-3137
Mailing Address - Fax:717-284-4164
Practice Address - Street 1:34 FAWN DR
Practice Address - Street 2:
Practice Address - City:QUARRYVILLE
Practice Address - State:PA
Practice Address - Zip Code:17566-9741
Practice Address - Country:US
Practice Address - Phone:717-284-3137
Practice Address - Fax:717-284-4164
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051520L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014918990001Medicaid
PA158841OtherMEDICARE GROUP NUMBER
PAF36891Medicare UPIN
PA0014918990001Medicaid