Provider Demographics
NPI:1730130709
Name:TRIGILIA, DONNA M (APRN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:TRIGILIA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:MELILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:GAYLORD FARMS RD.
Mailing Address - Street 2:PO BOX 400
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492
Mailing Address - Country:US
Mailing Address - Phone:203-284-2800
Mailing Address - Fax:203-679-3598
Practice Address - Street 1:GAYLORD FARMS RD.
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-284-2800
Practice Address - Fax:203-679-3598
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001431363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS83044Medicare UPIN
CT500000292Medicare ID - Type Unspecified