MEDICARE: ASPEN REILLY TRAUTZ 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	207N00000X	Dermatology Physician	MD489446	PA

General Provider Information

NPI Number	:	1376118059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASPEN REILLY TRAUTZ MD

Provider Business Mailing Address
First Line	:	1600 ST LUKES BLVD
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-5671
Country	:	US
Telephone Number	:	484-526-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 ST LUKES BLVD
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18045-5671
Country	:	US
Telephone Number	:	484-526-1000
Fax Number	:

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	05/29/2026

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Directions to “ ASPEN REILLY TRAUTZ MD” Practice Location

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