Healthcare Provider Details

I. General information

NPI: 1851899595
Provider Name (Legal Business Name): TRINITY TECHNOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2018
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 WHIPPOORWILL RD E
ARMONK NY
10504-1423
US

IV. Provider business mailing address

57 CHURCH STREET
FREEPORT NY
11520
US

V. Phone/Fax

Practice location:
  • Phone: 914-273-3333
  • Fax: 860-673-9200
Mailing address:
  • Phone: 646-930-7415
  • Fax: 646-930-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: POULAT ALAYEV
Title or Position: PRESIDENT
Credential:
Phone: 917-743-7777