Provider Demographics
NPI:1427068394
Name:TROSTLE, LORI CAROL (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:CAROL
Last Name:TROSTLE
Suffix:
Gender:F
Credentials:MD
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 276
Mailing Address - Street 2:
Mailing Address - City:SHERMANS DALE
Mailing Address - State:PA
Mailing Address - Zip Code:17090-0276
Mailing Address - Country:US
Mailing Address - Phone:717-582-2090
Mailing Address - Fax:717-582-7090
Practice Address - Street 1:4570 VALLEY RD
Practice Address - Street 2:
Practice Address - City:SHERMANS DALE
Practice Address - State:PA
Practice Address - Zip Code:17090
Practice Address - Country:US
Practice Address - Phone:717-582-2090
Practice Address - Fax:717-582-7090
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049444L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001846670 0005Medicaid
PA50026524OtherCAPITAL BLUE CROSS
PA50026524OtherCAPITAL BLUE CROSS
PA426968RZQMedicare ID - Type Unspecified