1174953418 NPI number — GINA LOUISE TRILLA B.A., C.A.S., M.S.ED

NPI Number: 1174953418
Health Care Provider/Practitioner: GINA LOUISE TRILLA B.A., C.A.S., M.S.ED

NPI Number : 1174953418 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174953418",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TRILLA",
    "FirstName": "GINA",
    "MiddleName": "LOUISE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "B.A., C.A.S., M.S.ED",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MEDICI",
    "OtherFirstName": "GINA",
    "OtherMiddleName": "LOUISE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "28 FIELDSTONE DR APT 10B",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARTSDALE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10530-1523",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-220-7526",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "20 CEDAR ST STE 302",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW ROCHELLE",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10801-5250",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "914-576-5292",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/23/2013",
    "LastUpdateDate": "11/23/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "252Y00000X",
        "TaxonomyName": "Early Intervention Provider Agency",
        "LicenseNumber": "844974",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}