Healthcare Provider Details

I. General information

NPI: 1528467461
Provider Name (Legal Business Name): THOMAS JAMES TROBIANO MSN, RN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2014
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-4442
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-2302
  • Fax: 410-328-6956
Mailing address:
  • Phone: 410-328-2302
  • Fax: 410-328-6956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR214385
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00515700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: