Provider Demographics
NPI:1295255081
Name:STRAUCH, PABLO ALDO (MD)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:ALDO
Last Name:STRAUCH
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 1:20958 45TH RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3234
Mailing Address - Country:US
Mailing Address - Phone:571-340-7595
Mailing Address - Fax:
Practice Address - Street 1:20958 45TH RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3234
Practice Address - Country:US
Practice Address - Phone:571-340-7595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305391208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics