Basic Information
Provider Information
NPI: 1497394878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRYKOWSKY
FirstName: MICHELE
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 227 LAUREL RD
Address2: STE 300
City: VOORHEES
State: NJ
PostalCode: 080438303
CountryCode: US
TelephoneNumber: 8566696050
FaxNumber: 8565283117
Practice Location
Address1: 227 LAUREL RD
Address2: STE 300
City: VOORHEES
State: NJ
PostalCode: 080438303
CountryCode: US
TelephoneNumber: 8564243323
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/02/2020
LastUpdateDate: 02/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102X26NJ00999700NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


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