Healthcare Provider Details

I. General information

NPI: 1831365345
Provider Name (Legal Business Name): SUSAN M. TROCCIOLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ENOTA DR NE STE 380
GAINESVILLE GA
30501-3475
US

IV. Provider business mailing address

1204 WENDELL AVE
SCHENECTADY NY
12308-2437
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-7099
  • Fax: 770-219-7923
Mailing address:
  • Phone: 917-673-8532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number70727
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number227067
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number91868
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number34617
License Number StateNH
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number70727
License Number StateWV
# 6
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number6390
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: