Provider Demographics
NPI:1073887055
Name:EDWARD M.STROH,M.D.,P.C
Entity Type:Organization
Organization Name:EDWARD M.STROH,M.D.,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:STROH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-536-9525
Mailing Address - Street 1:165 N VILLAGE AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3701
Mailing Address - Country:US
Mailing Address - Phone:516-536-9525
Mailing Address - Fax:516-536-9530
Practice Address - Street 1:165 N VILLAGE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3761
Practice Address - Country:US
Practice Address - Phone:516-536-9525
Practice Address - Fax:516-536-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175913-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty