Basic Information
Provider Information
NPI: 1467807925
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRONG
FirstName: ERIC
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 MICHIGAN AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200102916
CountryCode: US
TelephoneNumber: 2024763670
FaxNumber: 2024764741
Practice Location
Address1: 100 N ACADEMY AVE
Address2:  
City: DANVILLE
State: PA
PostalCode: 178222916
CountryCode: US
TelephoneNumber: 5702716012
FaxNumber: 5702717923
Other Information
ProviderEnumerationDate: 05/03/2016
LastUpdateDate: 04/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD473027PAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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