MEDICARE: KATHLEEN TROTTA MD

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	174400000X	Specialist	53011	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508833641
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN TROTTA MD

Provider Business Mailing Address
First Line	:	200 CORPORATE PL
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-3840
Country	:	US
Telephone Number	:	978-535-1344
Fax Number	:	781-255-0594

Provider Business Practice Location Address
First Line	:	200 CORPORATE PL
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-3840
Country	:	US
Telephone Number	:	978-535-1344
Fax Number	:	781-255-0594

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	07/08/2007

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Directions to “ KATHLEEN TROTTA MD” Practice Location

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