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General NPI Number Information
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NPI Number | 1730211145
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Entity Type | Individual
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Provider Name | TROY JOSEPH DEROSE CRNP, RNFA
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 925 CHESTNUT ST 6TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4216
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Country | US
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Telephone | 215-955-6760
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Fax |
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Provider Business Mailing Address
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Address Line | 16 INDIAN HILL LN
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-1731
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Country | US
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Telephone | 856-740-1727
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP007949
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License Number State | PA
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