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General NPI Number Information
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NPI Number | 1194031625
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Entity Type | Individual
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Provider Name | ERIC STEPHEN STRIEPECK O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2010
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Last Update Date | 08/21/2010
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Provider Practice Location Address
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Address Line | 130 BLACK HORSE PIKE STE D-4
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City | AUDUBON
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State | NJ
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Zip | 08106-1960
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Country | US
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Telephone | 856-672-3326
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FRANKLIN TOWN BLVD APT 418
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City | PHILADELPHIA
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State | PA
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Zip | 19103-1242
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Country | US
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Telephone | 570-881-5401
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00627200
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License Number State | NJ
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