Provider Demographics
NPI:1821394834
Name:ALSTON, TRINETTA (LPN)
Entity Type:Individual
Prefix:
First Name:TRINETTA
Middle Name:
Last Name:ALSTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MONTCLAIR AVE
Mailing Address - Street 2:UPPER
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-2124
Mailing Address - Country:US
Mailing Address - Phone:716-597-3487
Mailing Address - Fax:
Practice Address - Street 1:14 MONTCLAIR AVE STE 1
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-2124
Practice Address - Country:US
Practice Address - Phone:716-597-3487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304524164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse