Provider Demographics
NPI:1952360240
Name:STROBEL, RONALD EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EDWARD
Last Name:STROBEL
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 1:200 GRAND AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4363
Mailing Address - Country:US
Mailing Address - Phone:201-541-1220
Mailing Address - Fax:201-541-4005
Practice Address - Street 1:200 GRAND AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4363
Practice Address - Country:US
Practice Address - Phone:201-541-1220
Practice Address - Fax:201-541-4005
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05126500207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0684601Medicaid
E44154Medicare UPIN
NJ604085Medicare ID - Type Unspecified