Provider Demographics
NPI:1376753244
Name:TRAYSTMAN, AMOS (MS)
Entity Type:Individual
Prefix:
First Name:AMOS
Middle Name:
Last Name:TRAYSTMAN
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 BLACK ASH RD
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CT
Mailing Address - Zip Code:06370-1667
Mailing Address - Country:US
Mailing Address - Phone:860-334-0030
Mailing Address - Fax:
Practice Address - Street 1:595 VALLEY ST
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1901
Practice Address - Country:US
Practice Address - Phone:860-450-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist