Provider Demographics
NPI:1124379870
Name:STRAZZULLO, TERRY MICHAEL (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:MICHAEL
Last Name:STRAZZULLO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GREEN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1257
Mailing Address - Country:US
Mailing Address - Phone:609-504-9889
Mailing Address - Fax:
Practice Address - Street 1:112 HADDONTOWNE CT
Practice Address - Street 2:SUITE 303
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3661
Practice Address - Country:US
Practice Address - Phone:856-354-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01462600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist