Provider Demographics
NPI:1689605032
Name:TRAUTNER, NORBERT JOSEPH
Entity Type:Individual
Prefix:MR
First Name:NORBERT
Middle Name:JOSEPH
Last Name:TRAUTNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3989 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-2302
Mailing Address - Country:US
Mailing Address - Phone:215-947-1145
Mailing Address - Fax:
Practice Address - Street 1:347 2ND STREET PIKE
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-3831
Practice Address - Country:US
Practice Address - Phone:215-322-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0152630001Medicare ID - Type Unspecified