MEDICARE: ROBERT FREDERICK TRAFLET M.D.

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	2085R0202X	Diagnostic Radiology Physician	25MA04451100	NJ

General Provider Information

NPI Number	:	1609982073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT FREDERICK TRAFLET M.D.

Provider Business Mailing Address
First Line	:	410 CENTRE ST
Second Line	:
City	:	NUTLEY
State	:	NJ
Zip	:	07110-1635
Country	:	US
Telephone Number	:	973-661-0006
Fax Number	:	973-661-4473

Provider Business Practice Location Address
First Line	:	550 KINDERKAMACK RD
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1500
Country	:	US
Telephone Number	:	201-599-8100
Fax Number	:	201-599-8480

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	07/09/2007

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