Healthcare Provider Details
I. General information
NPI: 1174646244
Provider Name (Legal Business Name): TRINITAS EMERGENCY SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2007
Last Update Date: 05/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
225 WILLIAMSON ST
ELIZABETH NJ
07207
US
IV. Provider business mailing address
3114 CROASDAILE DR STE 200
DURHAM NC
27705-2508
US
V. Phone/Fax
- Phone: 908-994-5000
- Fax: 919-425-0478
- Phone: 919-425-1565
- Fax: 919-425-0478
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207PP0204X |
| Taxonomy | Pediatric Emergency Medicine (Emergency Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
R
SCOTT
Title or Position: PRESIDENT
Credential: MD
Phone: 919-425-1565