Healthcare Provider Details

I. General information

NPI: 1831756386
Provider Name (Legal Business Name): MARINA GEORGETTE TROTTA RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARINA GEORGETTE RUTHERFORD RN BSN

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 BURROWS ST
PITTSBURGH PA
15213-2201
US

IV. Provider business mailing address

127 BRIDLE RD
GLENSHAW PA
15116-1434
US

V. Phone/Fax

Practice location:
  • Phone: 412-383-1550
  • Fax:
Mailing address:
  • Phone: 412-320-9519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN671117
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN671117
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: