MEDICARE: GREGORY J. TRAMUTA MD PC

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	2084P0800X	Psychiatry Physician	MD-016856E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	101305	OTHER	PA	INDEPENDENCE BLUE CROSS
2	2512877	OTHER	PA	AETNA

General Provider Information

NPI Number	:	1184674228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY J. TRAMUTA MD PC

Provider Business Mailing Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	SUITE 4B
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-1774
Fax Number	:	215-955-0150

Provider Business Practice Location Address
First Line	:	8200 FLOURTOWN AVE
Second Line	:	SUITE 4B
City	:	WYNDMOOR
State	:	PA
Zip	:	19038-7976
Country	:	US
Telephone Number	:	215-233-1774
Fax Number	:	215-955-0150

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GREGORY JOSEPH TRAMUTA
Credential	:	M.D.
Telephone Number	:	215-233-1774

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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