Healthcare Provider Details

I. General information

NPI: 1982414496
Provider Name (Legal Business Name): ERIC STRULOWITZ RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE UNIT 300
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

312 ALLATOONA SHORES DR
CANTON GA
30114-8599
US

V. Phone/Fax

Practice location:
  • Phone: 877-711-3418
  • Fax:
Mailing address:
  • Phone: 404-353-7854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License NumberRN104593
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: