Provider Demographics
NPI:1871649905
Name:TROIANO, MICHAEL A (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:TROIANO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1740 SOUTH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-8400
Mailing Address - Country:US
Mailing Address - Phone:215-546-1618
Mailing Address - Fax:215-546-9905
Practice Address - Street 1:1740 SOUTH STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-8400
Practice Address - Country:US
Practice Address - Phone:215-546-1618
Practice Address - Fax:215-546-9905
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005752213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102002197Medicaid
PA102002197Medicaid
PA108372E2XMedicare PIN
PA0899730002Medicare NSC