1497394878 NPI number — MS. MICHELE ANNE STRYKOWSKY CRNP

Table of content: MS. MICHELE ANNE STRYKOWSKY CRNP (NPI 1497394878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497394878 NPI number — MS. MICHELE ANNE STRYKOWSKY CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRYKOWSKY
Provider First Name:
MICHELE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497394878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/26/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 LAUREL RD
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
VOORHEES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08043-8303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-669-6050
Provider Business Mailing Address Fax Number:
856-528-3117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
227 LAUREL RD
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
VOORHEES
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08043-8303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-424-3323
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/02/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  26NJ00999700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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