Provider Demographics
NPI:1932452703
Name:STRULOWITZ, KEITH (APN- NP-C)
Entity type:Individual
Prefix:MR
First Name:KEITH
Middle Name:
Last Name:STRULOWITZ
Suffix:
Gender:M
Credentials:APN- NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HACKENSACK AVE APT 2118
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6583
Mailing Address - Country:US
Mailing Address - Phone:201-753-1122
Mailing Address - Fax:
Practice Address - Street 1:1160 ROUTE 46
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-2100
Practice Address - Country:US
Practice Address - Phone:973-313-8484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QU0200X
NC5010282261QU0200X
NJ26NJ00393800364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care