Provider Demographics
NPI:1639245343
Name:STRAZZELLA, WILLIAM D (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:D
Last Name:STRAZZELLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 HOSPITAL DR
Mailing Address - Street 2:SUITE 17B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-557-6030
Mailing Address - Fax:732-557-6032
Practice Address - Street 1:20 HOSPITAL DR
Practice Address - Street 2:SUITE 17B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-557-6030
Practice Address - Fax:732-557-6032
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB45158207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6588107Medicaid
E79679Medicare UPIN
615176Medicare ID - Type Unspecified