Healthcare Provider Details

I. General information

NPI: 1972179083
Provider Name (Legal Business Name): ALEXANDER TROTTIER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2021
Last Update Date: 06/28/2022
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 TOLL GATE RD
WARWICK RI
02886-2759
US

IV. Provider business mailing address

455 TOLL GATE RD
WARWICK RI
02886-2770
US

V. Phone/Fax

Practice location:
  • Phone: 401-737-7010
  • Fax: 401-736-1975
Mailing address:
  • Phone: 401-737-7010
  • Fax: 401-736-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberLPR00243
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: