Healthcare Provider Details

I. General information

NPI: 1639093891
Provider Name (Legal Business Name): MICHAEL WILKIN TROMBADORE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 ELM ST
MANCHESTER NH
03101-1305
US

IV. Provider business mailing address

151 RAVINE LAKE RD
BERNARDSVILLE NJ
07924-1407
US

V. Phone/Fax

Practice location:
  • Phone: 603-314-1701
  • Fax:
Mailing address:
  • Phone: 908-240-7763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: