Provider Demographics
NPI:1568757581
Name:TROMBLEY, KRISTEN ANNE (PT)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:ANNE
Last Name:TROMBLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HOLCOMB AVENUE
Mailing Address - Street 2:
Mailing Address - City:TICONDEROGA
Mailing Address - State:NY
Mailing Address - Zip Code:12883
Mailing Address - Country:US
Mailing Address - Phone:518-585-6169
Mailing Address - Fax:
Practice Address - Street 1:25 RIDGEWOOD ROAD
Practice Address - Street 2:SPRINGFIELD HOSPITAL
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156
Practice Address - Country:US
Practice Address - Phone:802-886-2172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010164-1225100000X
MA8337225100000X
PA009505225100000X
CT007812225100000X
VT040-0002673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist