Basic Information
| Provider Information | |||||||||
| NPI: | 1689842049 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRAYER | ||||||||
| FirstName: | TROY | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 KEISER BLVD | ||||||||
| Address2: | |||||||||
| City: | WYOMISSING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196103338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106858500 | ||||||||
| FaxNumber: | 6106854833 | ||||||||
| Practice Location | |||||||||
| Address1: | 2605 KEISER BLVD | ||||||||
| Address2: | |||||||||
| City: | WYOMISSING | ||||||||
| State: | PA | ||||||||
| PostalCode: | 196103338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6106858500 | ||||||||
| FaxNumber: | 6106854833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2008 | ||||||||
| LastUpdateDate: | 07/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | OS016928 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | FT1941497 | 01 | NJ | DEA | OTHER | OT012116 | 01 | PA | STATE LISCENCE | OTHER | D09619700 | 01 | NJ | CDS | OTHER | 25MB08709000 | 01 | NJ | STATE LICENSE | OTHER | OS016928 | 01 | PA | STATE LICENSE | OTHER |