Provider Demographics
NPI:1316811300
Name:TRICK, KAITLIN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KAITLIN
Middle Name:
Last Name:TRICK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MRS
Other - First Name:KAITLIN
Other - Middle Name:
Other - Last Name:ECKERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:35 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5529
Mailing Address - Country:US
Mailing Address - Phone:845-313-3886
Mailing Address - Fax:
Practice Address - Street 1:35 PARK AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5529
Practice Address - Country:US
Practice Address - Phone:845-313-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2025041933363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty