Healthcare Provider Details

I. General information

NPI: 1679741987
Provider Name (Legal Business Name): AMY L STRASSER PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SILVERSIDE RD STE 2
WILMINGTON DE
19810-3724
US

IV. Provider business mailing address

2700 SILVERSIDE RD STE 2
WILMINGTON DE
19810-3724
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-8421
  • Fax: 302-478-8422
Mailing address:
  • Phone: 302-478-8421
  • Fax: 302-478-8422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC50000301
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: