Provider Demographics
NPI:1437215407
Name:TROTMAN, ADINA (PA-C)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:TROTMAN
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 1:103 E 125TH ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1641
Mailing Address - Country:US
Mailing Address - Phone:212-774-3204
Mailing Address - Fax:212-996-3502
Practice Address - Street 1:103 E 125TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1641
Practice Address - Country:US
Practice Address - Phone:212-774-3204
Practice Address - Fax:212-996-3502
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011355363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant