Healthcare Provider Details
I. General information
NPI: 1881865905
Provider Name (Legal Business Name): RICHARD J STRAUSS, M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 NORTHERN BLVD SUITE 130
GREAT NECK NY
11021-5312
US
IV. Provider business mailing address
1000 NORTHERN BLVD SUITE 130
GREAT NECK NY
11021-5312
US
V. Phone/Fax
- Phone: 516-466-5260
- Fax: 516-466-5266
- Phone: 516-466-5260
- Fax: 516-466-5266
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 116377 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 116377 |
| License Number State | NY |
VIII. Authorized Official
Name:
RICHARD
J
STRAUSS
Title or Position: PHYSICIAN
Credential: M.D.P.C.
Phone: 516-466-5260