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General NPI Number Information
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NPI Number | 1295370963
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Entity Type | Individual
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Provider Name | TARA BETH TROFA MS, BSN, CRNA, CCRN
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Gender | Female
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Dates
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Enumeration Date | 11/16/2019
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 630 W 168TH ST
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City | NEW YORK
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State | NY
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Zip | 10032-3725
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Country | US
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Telephone | 704-902-8085
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Fax |
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Provider Business Mailing Address
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Address Line | 64 MIDLAND PL APT 2511
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City | TUCKAHOE
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State | NY
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Zip | 10707-4250
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Country | US
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Telephone | 704-902-8085
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 267282
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 781579
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 169590
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 124323
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License Number State | NC
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