Healthcare Provider Details

I. General information

NPI: 1902019987
Provider Name (Legal Business Name): EDEN A STRUNK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 ARCH STREET 6TH FLOOR
PHILADELPHIA PA
19107
US

IV. Provider business mailing address

1216 ARCH STREET 6TH FLOOR
PHILADELPHIA PA
19107
US

V. Phone/Fax

Practice location:
  • Phone: 215-981-0088
  • Fax: 215-864-6931
Mailing address:
  • Phone: 215-981-0088
  • Fax: 215-864-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: