Provider Demographics
NPI:1225006927
Name:STRAUSS, IRA M (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:M
Last Name:STRAUSS
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 1:150 BRICK BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-4848
Mailing Address - Country:US
Mailing Address - Phone:732-451-0063
Mailing Address - Fax:732-451-0059
Practice Address - Street 1:150 BRICK BLVD
Practice Address - Street 2:STE A
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-4848
Practice Address - Country:US
Practice Address - Phone:732-451-0063
Practice Address - Fax:732-451-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04787000207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0759309Medicaid
NJ535702B7DMedicare ID - Type Unspecified
NJ0759309Medicaid