Provider Demographics
NPI:1457318420
Name:TROMBA, JOSEPH L (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:L
Last Name:TROMBA
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 1:300 OLD COUNTRY RD STE 31
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4112
Mailing Address - Country:US
Mailing Address - Phone:516-742-5252
Mailing Address - Fax:516-742-7623
Practice Address - Street 1:300 OLD COUNTRY RD STE 31
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4112
Practice Address - Country:US
Practice Address - Phone:516-742-5252
Practice Address - Fax:516-742-7623
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174854207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E94377Medicare UPIN
83F191Medicare ID - Type Unspecified