Provider Demographics
NPI:1063184414
Name:TRUMPER, ALEX G (CPO)
Entity type:Individual
Prefix:MR
First Name:ALEX
Middle Name:G
Last Name:TRUMPER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 BLOOMFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:NY
Mailing Address - Zip Code:12972-2633
Mailing Address - Country:US
Mailing Address - Phone:518-320-5324
Mailing Address - Fax:
Practice Address - Street 1:106 W BAY PLZ
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1785
Practice Address - Country:US
Practice Address - Phone:518-324-6569
Practice Address - Fax:518-324-6570
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist