Basic Information
Provider Information
NPI: 1619168689
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRASSBURG
FirstName: ALEX
MiddleName: B
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: STRASSBURG
OtherFirstName: ALEXIS
OtherMiddleName: B
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 2
Mailing Information
Address1: 2 W CRESCENT PARK
Address2:  
City: WARREN
State: PA
PostalCode: 163652111
CountryCode: US
TelephoneNumber: 8147234973
FaxNumber:  
Practice Location
Address1: 2 W CRESCENT PARK
Address2:  
City: WARREN
State: PA
PostalCode: 163652111
CountryCode: US
TelephoneNumber: 8147234973
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2007
LastUpdateDate: 05/09/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD071700LPAY Allopathic & Osteopathic PhysiciansInternal Medicine 
207RS0012XMD071700LPAN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207R00000X247087NYN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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