Healthcare Provider Details

I. General information

NPI: 1508108564
Provider Name (Legal Business Name): EILEEN MARIE TRIFILETTI RNC, ANP,GNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2013
Last Update Date: 03/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 SMITH HILL RD
AIRMONT NY
10952-4219
US

IV. Provider business mailing address

25 SMITH HILL RD
AIRMONT NY
10952-4219
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-4860
  • Fax: 201-236-3888
Mailing address:
  • Phone: 845-368-4860
  • Fax: 201-236-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number398792-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number398792-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number398792-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163WN0800X
TaxonomyNeuroscience Registered Nurse
License Number398792-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: