Basic Information
| Provider Information | |||||||||
| NPI: | 1194031625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRIEPECK | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | STEPHEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 FRANKLIN TOWN BLVD APT 418 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191031242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708815401 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 BLACK HORSE PIKE STE D-4 | ||||||||
| Address2: | |||||||||
| City: | AUDUBON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081061960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566723326 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2010 | ||||||||
| LastUpdateDate: | 08/21/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 27OA00627200 | NJ | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.