Provider Demographics
NPI:1457423998
Name:TROCHE, JEANNETTE SARAHI (MT)
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:SARAHI
Last Name:TROCHE
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1338
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-5338
Mailing Address - Country:US
Mailing Address - Phone:787-849-1495
Mailing Address - Fax:787-849-1495
Practice Address - Street 1:345 RD. KM. 2.1 PLAZA MONSERRATE
Practice Address - Street 2:
Practice Address - City:HORMIGUEROS
Practice Address - State:PR
Practice Address - Zip Code:00660
Practice Address - Country:US
Practice Address - Phone:787-849-1495
Practice Address - Fax:787-849-1495
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5267246RM2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31331Medicare ID - Type Unspecified