Provider Demographics
NPI:1689870172
Name:STRAW, JEFFREY LEE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LEE
Last Name:STRAW
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206-600 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M5G1X5
Mailing Address - Country:CA
Mailing Address - Phone:416-586-5058
Mailing Address - Fax:416-586-4719
Practice Address - Street 1:206-600 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M5G1X5
Practice Address - Country:CA
Practice Address - Phone:416-586-5058
Practice Address - Fax:416-586-4719
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052805363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical