Provider Demographics
NPI:1811162563
Name:TREJO, NANCY ELENA (RPA-C)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELENA
Last Name:TREJO
Suffix:
Gender:F
Credentials:RPA-C
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Other - Credentials:
Mailing Address - Street 1:3003 NEW HYDE PARK RD STE 401
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1214
Mailing Address - Country:US
Mailing Address - Phone:516-224-2400
Mailing Address - Fax:516-224-2461
Practice Address - Street 1:525 EAST 68TH ROOM, M-528
Practice Address - Street 2:DEPT. OF MEDICINE, BOX 130
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:212-746-4209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY05034-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant