MEDICARE: DR. RAYMOND R STROCKO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083X0100X	Occupational Medicine Physician	C1-0001608	DE

General Provider Information

NPI Number	:	1225165350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND R STROCKO M.D.

Provider Business Mailing Address
First Line	:	D-5014 DUPONT CO
Second Line	:	1007 N. MARKET ST.
City	:	WILMINGTON
State	:	DE
Zip	:	19898-0001
Country	:	US
Telephone Number	:	302-774-8666
Fax Number	:	302-773-6030

Provider Business Practice Location Address
First Line	:	D-5014 DUPONT CO
Second Line	:	1007 N. MARKET ST.
City	:	WILMINGTON
State	:	DE
Zip	:	19898-0001
Country	:	US
Telephone Number	:	302-774-8666
Fax Number	:	302-773-6030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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