Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD065944L | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | C10006597 | DE |
NPI | 1235182536 |
---|---|
Provider Name | Dr. Glenn Stryjewski |
First Address | Rockland, DE 19723-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 27/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001907471 | (05) | PA |
1302078 | (05) | MD |
5034108 | (05) | NJ |
H24153 | (02) |