Provider Demographics
NPI:1356517080
Name:STRULOWITZ, LEONARD (OD)
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:STRULOWITZ
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 MILLBURN AVE
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-3330
Mailing Address - Country:US
Mailing Address - Phone:973-379-2544
Mailing Address - Fax:973-379-1317
Practice Address - Street 1:551 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-3330
Practice Address - Country:US
Practice Address - Phone:973-379-2544
Practice Address - Fax:973-379-1317
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2595152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT77715Medicare UPIN