Provider Demographics
NPI:1477837797
Name:STRUNK, LORETTA D'ANGELO (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:D'ANGELO
Last Name:STRUNK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:4 KASTAL DR
Mailing Address - Street 2:
Mailing Address - City:RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:11961-1932
Mailing Address - Country:US
Mailing Address - Phone:631-793-7845
Mailing Address - Fax:631-476-7675
Practice Address - Street 1:701 ROUTE 25A
Practice Address - Street 2:SUITE B3
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766
Practice Address - Country:US
Practice Address - Phone:631-476-7676
Practice Address - Fax:631-476-7675
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY003936-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant