Healthcare Provider Details

I. General information

NPI: 1316907827
Provider Name (Legal Business Name): TINA MARIE TRZASKA JOYCE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TINA MARIE TRZASKA DO

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8007 AUBURN RD SUITE 3
CONCORD TWP OH
44077-9610
US

IV. Provider business mailing address

8007 AUBURN RD SUITE 3
CONCORD TWP OH
44077-9600
US

V. Phone/Fax

Practice location:
  • Phone: 440-375-5502
  • Fax: 440-350-0955
Mailing address:
  • Phone: 440-375-5520
  • Fax: 440-350-0955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-008375
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: