Provider Demographics
NPI:1659660181
Name:TROTTO, MARY (EDD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:TROTTO
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 MAHALANI ST RM 19A
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2521
Mailing Address - Country:US
Mailing Address - Phone:808-244-7467
Mailing Address - Fax:808-242-5835
Practice Address - Street 1:95 MAHALANI ST RM 19A
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2521
Practice Address - Country:US
Practice Address - Phone:808-244-7467
Practice Address - Fax:808-242-5835
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-1577225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist