Healthcare Provider Details

I. General information

NPI: 1518279736
Provider Name (Legal Business Name): LISA S. TROY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA S. KREMEN M.DM

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 RAMAPO RD NORTH ROCKLAND PEDIATRICS
GARNERVILLE NY
10923-1552
US

IV. Provider business mailing address

1002 TOWER DR
EDGEWATER NJ
07020-2204
US

V. Phone/Fax

Practice location:
  • Phone: 845-947-1772
  • Fax:
Mailing address:
  • Phone: 201-390-0955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number257756
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: