Provider Demographics
NPI:1467339804
Name:DEONARINE, TRISHA ALYSSA
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ALYSSA
Last Name:DEONARINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 67TH AVE APT 5B
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4931
Mailing Address - Country:US
Mailing Address - Phone:929-350-8908
Mailing Address - Fax:
Practice Address - Street 1:9801 67TH AVE APT 5B
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4931
Practice Address - Country:US
Practice Address - Phone:929-350-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1923723251174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist