Provider Demographics
NPI:1023742749
Name:TROETTI, ROBERT JAMES (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:TROETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 BROADHOLLOW RD STE A22
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-3725
Mailing Address - Country:US
Mailing Address - Phone:631-249-0011
Mailing Address - Fax:631-249-1793
Practice Address - Street 1:535 BROADHOLLOW RD STE A22
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3725
Practice Address - Country:US
Practice Address - Phone:631-249-0011
Practice Address - Fax:631-249-1793
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007657111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor