Provider Demographics
NPI:1588929517
Name:TROY, MARYANN
Entity type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:
Last Name:TROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 YORKTOWN ST
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-2436
Mailing Address - Country:US
Mailing Address - Phone:516-764-0722
Mailing Address - Fax:
Practice Address - Street 1:2625 YORKTOWN ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-2436
Practice Address - Country:US
Practice Address - Phone:516-764-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist