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General NPI Number Information
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NPI Number | 1265141444
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Entity Type | Organization
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Legal Business Name | TRI AMERICA MEDICINE LLC
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 2185 LEMOINE AVE UNIT 1H
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City | FORT LEE
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State | NJ
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Zip | 07024-6030
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Country | US
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Telephone | 844-755-8102
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Fax |
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Provider Business Mailing Address
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Address Line | 2185 LEMOINE AVE UNIT 1H
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City | FORT LEE
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State | NJ
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Zip | 07024-6030
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Country | US
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Telephone | 844-755-8102
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LORI KOLIN
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Credential |
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Telephone | 844-755-8102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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