Provider Demographics
NPI:1023069135
Name:TRAMUTA, GREGORY JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:TRAMUTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 FLOURTOWN AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7976
Mailing Address - Country:US
Mailing Address - Phone:215-233-1774
Mailing Address - Fax:215-955-0150
Practice Address - Street 1:8200 FLOURTOWN AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:WYNDMOOR
Practice Address - State:PA
Practice Address - Zip Code:19038-7976
Practice Address - Country:US
Practice Address - Phone:215-233-1774
Practice Address - Fax:215-955-0150
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-016856E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA159944OtherINDEPENDENCE BLUE CROSS
PA159944OtherINDEPENDENCE BLUE CROSS
PAB40284Medicare UPIN