Provider Demographics
NPI:1023842002
Name:TROIA, SAMUEL DOMINIC II (OTD OTR/L)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:DOMINIC
Last Name:TROIA
Suffix:II
Gender:M
Credentials:OTD OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26615 BLONDO CT
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:NE
Mailing Address - Zip Code:68069-6215
Mailing Address - Country:US
Mailing Address - Phone:402-699-0095
Mailing Address - Fax:
Practice Address - Street 1:12100 W CENTER RD STE 518
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-3960
Practice Address - Country:US
Practice Address - Phone:402-933-2882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2603225XP0200X
NE225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics