Provider Demographics
NPI:1255398616
Name:STRASSER, STEPHEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:STRASSER
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:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:518-284-2223
Mailing Address - Fax:518-234-8449
Practice Address - Street 1:519-1STATE HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:SHARON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13459
Practice Address - Country:US
Practice Address - Phone:518-284-2223
Practice Address - Fax:518-234-8449
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209325207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01797213Medicaid
NY71400GMedicare ID - Type UnspecifiedUPSTATE
NYG64152Medicare UPIN