Provider Demographics
NPI:1174055636
Name:TRINH, ELYSE V (MD)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:V
Last Name:TRINH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 ALLENS AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-5010
Mailing Address - Country:US
Mailing Address - Phone:401-780-2511
Mailing Address - Fax:401-780-2565
Practice Address - Street 1:31 ATWOOD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-3410
Practice Address - Country:US
Practice Address - Phone:401-444-0590
Practice Address - Fax:401-396-2084
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA159067207V00000X
390200000X
RIMD19227207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program