Healthcare Provider Details

I. General information

NPI: 1497660401
Provider Name (Legal Business Name): GWENDOLYN STRACHAN-RAYMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 CRANFORD PL
TEANECK NJ
07666-4705
US

IV. Provider business mailing address

42 CRANFORD PL
TEANECK NJ
07666-4705
US

V. Phone/Fax

Practice location:
  • Phone: 646-290-8708
  • Fax:
Mailing address:
  • Phone: 646-290-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR19052000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number623064-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: