Provider Demographics
NPI:1720101975
Name:STROUSTRUP, ANNEMARIE (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:STROUSTRUP
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:ANNEMARIE
Other - Middle Name:
Other - Last Name:STROUSTRUP SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:COHEN CHILDREN'S MEDICAL CENTER
Mailing Address - Street 2:269-01 76TH AVENUE, NICU CH 346
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-3440
Mailing Address - Fax:
Practice Address - Street 1:COHEN CHILDREN'S MEDICAL CENTER
Practice Address - Street 2:269-01 76TH AVENUE, NICU
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242108208000000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics