Provider Demographics
NPI:1114919032
Name:STRIZICH, GREGORY J (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:STRIZICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 NORMANSKILL BLVD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1352
Mailing Address - Country:US
Mailing Address - Phone:518-478-0948
Mailing Address - Fax:518-478-0968
Practice Address - Street 1:3 NORMANSKILL BLVD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1352
Practice Address - Country:US
Practice Address - Phone:518-478-0948
Practice Address - Fax:518-478-0968
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193380207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01461403Medicaid
NYF72846Medicare UPIN
NYRA2987Medicare PIN