Provider Demographics
NPI:1417306002
Name:TROJANSKY, LIA (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LIA
Middle Name:
Last Name:TROJANSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CROSBY STREET
Mailing Address - Street 2:FLOOR 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012
Mailing Address - Country:US
Mailing Address - Phone:212-993-6131
Mailing Address - Fax:646-869-1039
Practice Address - Street 1:132 CROSBY STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012
Practice Address - Country:US
Practice Address - Phone:212-993-6131
Practice Address - Fax:646-869-1039
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NY019716363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant