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General NPI Number Information
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NPI Number | 1174953418
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Entity Type | Individual
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Provider Name | GINA LOUISE TRILLA B.A., C.A.S., M.S.ED
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Gender | Female
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Dates
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Enumeration Date | 11/23/2013
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Last Update Date | 11/23/2013
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Provider Practice Location Address
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Address Line | 20 CEDAR ST STE 302
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5250
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Country | US
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Telephone | 914-576-5292
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Fax |
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Provider Business Mailing Address
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Address Line | 28 FIELDSTONE DR APT 10B
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City | HARTSDALE
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State | NY
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Zip | 10530-1523
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Country | US
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Telephone | 845-220-7526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 844974
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License Number State | NY
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