Healthcare Provider Details

I. General information

NPI: 1558201020
Provider Name (Legal Business Name): CORINNE MINA STROUP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ RM 215
CAMDEN NJ
08103-1438
US

IV. Provider business mailing address

5 HARMONY CIR
MALVERN PA
19355-2881
US

V. Phone/Fax

Practice location:
  • Phone: 856-628-5777
  • Fax:
Mailing address:
  • Phone: 267-279-3253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: