MEDICARE: PABLO ALDO STRAUCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	305391	NY

General Provider Information

NPI Number	:	1295255081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PABLO ALDO STRAUCH MD

Provider Business Mailing Address
First Line	:	20958 45TH RD
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3234
Country	:	US
Telephone Number	:	571-340-7595
Fax Number	:

Provider Business Practice Location Address
First Line	:	20958 45TH RD
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3234
Country	:	US
Telephone Number	:	571-340-7595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2017
Last Update Date	:	07/24/2022

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