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General NPI Number Information
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NPI Number | 1972921807
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Entity Type | Individual
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Provider Name | DOUGLAS ALLEN TREMBLAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 10 E 102ND ST
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City | NEW YORK
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State | NY
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Zip | 10029-6030
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Country | US
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Telephone | 212-241-6756
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E 42ND ST FL 9
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City | NEW YORK
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State | NY
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Zip | 10017-5699
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Country | US
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Telephone | 646-605-8186
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 282022
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 282022
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License Number State | NY
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