Provider Demographics
NPI:1013016534
Name:STRASSMAN, RICK JAN (MD)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:JAN
Last Name:STRASSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1206 N RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2811
Mailing Address - Country:US
Mailing Address - Phone:505-747-0102
Mailing Address - Fax:505-758-9758
Practice Address - Street 1:1206 N RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2811
Practice Address - Country:US
Practice Address - Phone:505-747-0102
Practice Address - Fax:505-758-9758
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM851052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A47150Medicare UPIN