Healthcare Provider Details

I. General information

NPI: 1124039466
Provider Name (Legal Business Name): JOHN B TROUERN-TREND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 HART ST BUILDING D
NEW BRITAIN CT
06052-1743
US

IV. Provider business mailing address

4 FARM SPRINGS RD PROHEALTH PHYSICIANS
FARMINGTON CT
06032-2573
US

V. Phone/Fax

Practice location:
  • Phone: 860-223-5396
  • Fax: 860-225-1005
Mailing address:
  • Phone: 860-284-5200
  • Fax: 860-284-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number016421
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: