Healthcare Provider Details

I. General information

NPI: 1962075515
Provider Name (Legal Business Name): NAOMIE B TROFORT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 GERALDINE CIR
TRUMBULL CT
06611-4524
US

IV. Provider business mailing address

86 GERALDINE CIR
TRUMBULL CT
06611-4524
US

V. Phone/Fax

Practice location:
  • Phone: 203-512-7734
  • Fax:
Mailing address:
  • Phone: 120-351-2773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number13398
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number89236
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: