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General NPI Number Information
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NPI Number | 1548667975
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Entity Type | Organization
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Legal Business Name | TRIVIUM OF NEW YORK
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 1216 E 86TH ST
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City | BROOKLYN
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State | NY
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Zip | 11236-4928
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Country | US
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Telephone | 877-223-9228
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Fax |
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Provider Business Mailing Address
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Address Line | 90 HEATHCOTE RD
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City | ELMONT
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State | NY
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Zip | 11003-1405
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Country | US
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Telephone | 877-223-9228
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. NIGEL ONIKO DOUGLAS
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Credential | OWNER
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Telephone | 877-223-9228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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