Provider Demographics
NPI:1811963952
Name:TRIFOGLIO, STEPHANIE (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:TRIFOGLIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:TRIFOGLIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7500 GREENWAY CENTER DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3502
Mailing Address - Country:US
Mailing Address - Phone:301-345-5857
Mailing Address - Fax:301-474-5621
Practice Address - Street 1:7500 GREENWAY CENTER DR
Practice Address - Street 2:SUITE 430
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3502
Practice Address - Country:US
Practice Address - Phone:301-345-5857
Practice Address - Fax:301-474-5621
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD37934207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDTR047347Medicare ID - Type Unspecified
E14896Medicare UPIN