Organization Active NPI

Trokhan Dermatology, LLC

  • Dermatology Physician
  • Closter, NJ
National Provider Identifier
1437185162
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA08034800 Issued in NJ
Legal business name
TROKHAN DERMATOLOGY, LLC
Practice address
235 Closter Dock Rd
Closter, NJ 07624-1907
Phone
(201) 768-6101
Fax
(201) 768-2370
NPI assigned
Jun 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eileen Q Trokhan, M.D.NPI 1447214804
Title
Medical Doctor
Phone
(201) 768-6101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 25MA08034800 NJ Primary

Addresses

Primary practice location

235 Closter Dock Rd
Closter, NJ 07624-1907

Mailing address

235 Closter Dock Rd
Closter, NJ 07624-1907
Phone (201) 768-6101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060724000053 NJ Part B Supplier - Clinic/Group Practice 9739192568 Receives reassigned benefits from 7 practitioners
Practice locations: Closter, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1055049Trokhan Dermatology, LLC235 Closter Dock Rd, Closter, NJ 07624ComplianceJul 29, 2028

National Provider Directory

National Provider Directory

Locations

216 Engle St
Ste 104
Englewood, NJ 07631
Phone (201) 569-5678

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437185162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 CLOSTER DOCK RD",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076241907",
            "telephone_number": "201-768-6101",
            "fax_number": "201-768-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 CLOSTER DOCK RD",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076241907",
            "telephone_number": "201-768-6101",
            "fax_number": "201-768-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TROKHAN DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TROKHAN",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "201-768-6101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA08034800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Closter, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.