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General NPI Number Information
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NPI Number | 1205091436
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Entity Type | Individual
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Provider Name | ELAINE M TRENTACOSTA RN
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Gender | Female
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 11/01/2013
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Provider Practice Location Address
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Address Line | 1240 BROADCAST PLZ
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City | MERRICK
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State | NY
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Zip | 11566-3461
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Country | US
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Telephone | 516-546-8000
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Fax | 516-868-7394
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Provider Business Mailing Address
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Address Line | 91-31 QUEENS BLVD.
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City | ELMHURST
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State | NY
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Zip | 11373
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Country | US
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Telephone | 718-779-7000
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Fax | 718-458-5379
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 464769
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License Number State | NY
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