Provider Demographics
NPI:1851686331
Name:TRABAND, ANASTASIA (MD)
Entity type:Individual
Prefix:
First Name:ANASTASIA
Middle Name:
Last Name:TRABAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GRANITE POINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1992
Mailing Address - Country:US
Mailing Address - Phone:610-378-1344
Mailing Address - Fax:610-378-5169
Practice Address - Street 1:1 GRANITE POINT DR STE 100
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1992
Practice Address - Country:US
Practice Address - Phone:610-378-1344
Practice Address - Fax:610-378-9508
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD454223207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1031125400005Medicaid
PA1031125400006Medicaid
PA1031125400003Medicaid