Provider Demographics
NPI:1194031625
Name:STRIEPECK, ERIC STEPHEN (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:STEPHEN
Last Name:STRIEPECK
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 1:1 FRANKLIN TOWN BLVD APT 418
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-1242
Mailing Address - Country:US
Mailing Address - Phone:570-881-5401
Mailing Address - Fax:
Practice Address - Street 1:130 BLACK HORSE PIKE STE D-4
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1960
Practice Address - Country:US
Practice Address - Phone:856-672-3326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00627200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist