Provider Demographics
NPI:1336228279
Name:STRELL, ROBERT FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FREDERICK
Last Name:STRELL
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 1:317 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3807
Mailing Address - Country:US
Mailing Address - Phone:201-222-0082
Mailing Address - Fax:201-222-6799
Practice Address - Street 1:317 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3807
Practice Address - Country:US
Practice Address - Phone:201-222-0082
Practice Address - Fax:201-222-6799
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06812300208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG94370Medicare UPIN
NJ027637Medicare ID - Type Unspecified