Provider Demographics
NPI:1982900296
Name:IRVING D STROUSE MD PA
Entity Type:Organization
Organization Name:IRVING D STROUSE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:D
Authorized Official - Last Name:STROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-229-4333
Mailing Address - Street 1:279 3RD AVE
Mailing Address - Street 2:SUTIE 504
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6211
Mailing Address - Country:US
Mailing Address - Phone:732-229-4333
Mailing Address - Fax:732-571-1937
Practice Address - Street 1:279 3RD AVE
Practice Address - Street 2:SUTIE 504
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6211
Practice Address - Country:US
Practice Address - Phone:732-229-4333
Practice Address - Fax:732-571-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02268800207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C53269Medicare PIN