Healthcare Provider Details

I. General information

NPI: 1326532193
Provider Name (Legal Business Name): JENNA L TROIANI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 FRANCE AVE S STE 1100
EDINA MN
55435-5936
US

IV. Provider business mailing address

888 WORCESTER ST STE 130
WELLESLEY MA
02482-3744
US

V. Phone/Fax

Practice location:
  • Phone: 888-964-6681
  • Fax: 888-662-0859
Mailing address:
  • Phone: 888-964-6681
  • Fax: 339-686-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18004099
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: