Healthcare Provider Details

I. General information

NPI: 1790133882
Provider Name (Legal Business Name): ROHIT TREHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2016
Last Update Date: 06/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 STATE ST
SPRINGFIELD MA
01109-4101
US

IV. Provider business mailing address

350 N CLARK ST STE 600
CHICAGO IL
60654-4782
US

V. Phone/Fax

Practice location:
  • Phone: 413-736-0027
  • Fax:
Mailing address:
  • Phone: 312-274-4524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN1857295
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: