Provider Demographics
NPI:1992092944
Name:TREPPER, RANDI N
Entity type:Individual
Prefix:MRS
First Name:RANDI
Middle Name:N
Last Name:TREPPER
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 1:4 HOEY CIR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3718
Mailing Address - Country:US
Mailing Address - Phone:845-354-1552
Mailing Address - Fax:
Practice Address - Street 1:4 HOEY CIR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3718
Practice Address - Country:US
Practice Address - Phone:845-354-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TAO9045200174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator