Provider Demographics
NPI:1225165350
Name:STROCKO, RAYMOND R (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:R
Last Name:STROCKO
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:D-5014 DUPONT CO
Mailing Address - Street 2:1007 N. MARKET ST.
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19898-0001
Mailing Address - Country:US
Mailing Address - Phone:302-774-8666
Mailing Address - Fax:302-773-6030
Practice Address - Street 1:D-5014 DUPONT CO
Practice Address - Street 2:1007 N. MARKET ST.
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19898-0001
Practice Address - Country:US
Practice Address - Phone:302-774-8666
Practice Address - Fax:302-773-6030
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-00016082083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine