Provider Demographics
NPI:1083741599
Name:STRAUSS, STANLEY A (OD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:A
Last Name:STRAUSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 PENNFORD PL
Mailing Address - Street 2:
Mailing Address - City:BOOTHWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19061-2407
Mailing Address - Country:US
Mailing Address - Phone:610-494-8252
Mailing Address - Fax:302-475-6919
Practice Address - Street 1:1809 MARSH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4505
Practice Address - Country:US
Practice Address - Phone:302-475-8897
Practice Address - Fax:302-475-6919
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI3-0001170152W00000X
PAOE005869P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEDE1170OtherVBA VISION PLAN
DE99965OtherAETNA HEALTHCARE
DE1741OtherCOVENTRY HEALTHCARE
DEU44327OtherBLUECROSSBLUESHIELD OF DE
DEDE1170OtherEYEMED VISION CARE
DE510349416-007OtherCIGNA HEALTH PLAN
PA056380Medicare ID - Type Unspecified
DEU44327Medicare UPIN
DEU44327OtherBLUECROSSBLUESHIELD OF DE
DEDE1170OtherVBA VISION PLAN