Provider Demographics
NPI:1457696924
Name:WILLIAM STRAZZELLA DO LLC
Entity type:Organization
Organization Name:WILLIAM STRAZZELLA DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAZZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO LLC
Authorized Official - Phone:732-557-6030
Mailing Address - Street 1:20 HOSPITAL DR
Mailing Address - Street 2:SUITE 17B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6434
Mailing Address - Country:US
Mailing Address - Phone:732-557-6030
Mailing Address - Fax:732-557-6032
Practice Address - Street 1:20 HOSPITAL DR
Practice Address - Street 2:SUITE 17 B
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6434
Practice Address - Country:US
Practice Address - Phone:732-557-6030
Practice Address - Fax:732-557-6032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-10
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB45158281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital