Healthcare Provider Details

I. General information

NPI: 1710243241
Provider Name (Legal Business Name): OSCAR TRUJILLO MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORT WASHINGTON AVE. HARKNESS PAVILION 7TH FLOOR
NEW YORK NY
10032
US

IV. Provider business mailing address

180 FORT WASHINGTON AVE. HARKNESS PAVILION 8-843
NEW YORK NY
10032
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-8555
  • Fax:
Mailing address:
  • Phone: 212-305-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number292562
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: