Provider Demographics
NPI:1467608968
Name:TROUP, RANDY A JR (PA)
Entity Type:Individual
Prefix:MR
First Name:RANDY
Middle Name:A
Last Name:TROUP
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 KEARNS AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205
Mailing Address - Country:US
Mailing Address - Phone:724-859-7512
Mailing Address - Fax:
Practice Address - Street 1:1957 KEARNS AVE
Practice Address - Street 2:SUITE 2100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4117
Practice Address - Country:US
Practice Address - Phone:724-859-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATMA051966363AS0400X
PAMA053525363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical