Provider Demographics
NPI:1144580333
Name:VINCENTIU POPA MD LLC
Entity Type:Organization
Organization Name:VINCENTIU POPA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VINCENTIU
Authorized Official - Middle Name:
Authorized Official - Last Name:POPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-751-0752
Mailing Address - Street 1:417 RIVER MEWS LN
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-3109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:719 BUTTERNUT DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2281
Practice Address - Country:US
Practice Address - Phone:201-925-0277
Practice Address - Fax:888-766-8193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty