Provider Demographics
NPI:1386973923
Name:STANLEY STRICK M.D., P.C.
Entity type:Organization
Organization Name:STANLEY STRICK M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-428-4100
Mailing Address - Street 1:2614 213TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2533
Mailing Address - Country:US
Mailing Address - Phone:718-428-4100
Mailing Address - Fax:
Practice Address - Street 1:2614 213TH ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2533
Practice Address - Country:US
Practice Address - Phone:718-428-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY82775261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD83455Medicare UPIN