Provider Demographics
NPI:1710124748
Name:DR. MOLLY B. TROSTLE, DO, INTERNAL MEDICINE, INC.
Entity Type:Organization
Organization Name:DR. MOLLY B. TROSTLE, DO, INTERNAL MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:TROSTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-419-8084
Mailing Address - Street 1:881 HILLS PLZ
Mailing Address - Street 2:SUITE 530
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4213
Mailing Address - Country:US
Mailing Address - Phone:814-419-8084
Mailing Address - Fax:814-419-8053
Practice Address - Street 1:881 HILLS PLZ
Practice Address - Street 2:SUITE530
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-4213
Practice Address - Country:US
Practice Address - Phone:814-419-8084
Practice Address - Fax:814-419-8053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-13
Last Update Date:2009-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-011902261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
H50269Medicare UPIN