Provider Demographics
NPI:1386682904
Name:TROISI, ERNEST (DPM)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:
Last Name:TROISI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5703
Mailing Address - Country:US
Mailing Address - Phone:302-834-3575
Mailing Address - Fax:302-834-4066
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:STE 107
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4777
Practice Address - Country:US
Practice Address - Phone:302-834-3575
Practice Address - Fax:302-834-4066
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1000083213E00000X
DEE10000083213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000148250Medicaid
DE510317427OtherPRACTICE TIN
DE510317427OtherPRACTICE TIN
DE000L84E75Medicare ID - Type UnspecifiedIND PROV NUMBER
DEG00275Medicare PIN
DET26875Medicare UPIN