Healthcare Provider Details

I. General information

NPI: 1114381928
Provider Name (Legal Business Name): ALI STROCHAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CENTURY PKWY STE A
MOUNT LAUREL NJ
08054-1129
US

IV. Provider business mailing address

PO BOX 22581
NEW YORK NY
10087-2581
US

V. Phone/Fax

Practice location:
  • Phone: 856-778-4700
  • Fax: 856-778-1154
Mailing address:
  • Phone: 856-669-6050
  • Fax: 856-528-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA10826600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: