Provider Demographics
NPI:1558027276
Name:ANTHONY TREZZA, LLC
Entity Type:Organization
Organization Name:ANTHONY TREZZA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TREZZA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:203-666-2002
Mailing Address - Street 1:3 ARMSTRONG RD # 1026
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-4706
Mailing Address - Country:US
Mailing Address - Phone:203-666-2002
Mailing Address - Fax:203-202-3760
Practice Address - Street 1:35 OLD TAVERN RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3450
Practice Address - Country:US
Practice Address - Phone:203-666-2002
Practice Address - Fax:203-202-3760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health