MEDICARE: ALYSSA TROCINO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1417445602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA TROCINO

Provider Business Mailing Address
First Line	:	8440 153RD AVE APT 1F
Second Line	:
City	:	HOWARD BEACH
State	:	NY
Zip	:	11414-1917
Country	:	US
Telephone Number	:	917-440-0977
Fax Number	:

Provider Business Practice Location Address
First Line	:	8440 153RD AVE APT 1F
Second Line	:
City	:	HOWARD BEACH
State	:	NY
Zip	:	11414-1917
Country	:	US
Telephone Number	:	917-440-0977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	04/24/2018

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Directions to “ ALYSSA TROCINO ” Practice Location

Language	Start Address	Practice Location

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