Healthcare Provider Details

I. General information

NPI: 1225165350
Provider Name (Legal Business Name): RAYMOND R STROCKO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

D-5014 DUPONT CO 1007 N. MARKET ST.
WILMINGTON DE
19898-0001
US

IV. Provider business mailing address

D-5014 DUPONT CO 1007 N. MARKET ST.
WILMINGTON DE
19898-0001
US

V. Phone/Fax

Practice location:
  • Phone: 302-774-8666
  • Fax: 302-773-6030
Mailing address:
  • Phone: 302-774-8666
  • Fax: 302-773-6030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberC1-0001608
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: