Provider Demographics
NPI:1134491327
Name:STRUMKOVSKY, LYALYA OLGA (MD)
Entity type:Individual
Prefix:DR
First Name:LYALYA
Middle Name:OLGA
Last Name:STRUMKOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1007 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1737
Mailing Address - Country:US
Mailing Address - Phone:908-720-4262
Mailing Address - Fax:732-369-3209
Practice Address - Street 1:1005 NORTH WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-0881
Practice Address - Country:US
Practice Address - Phone:732-968-8900
Practice Address - Fax:732-968-4609
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA09086600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program