Provider Demographics
NPI:1164450177
Name:OLARU, GABRIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:OLARU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 E 75TH ST OFC 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3317
Mailing Address - Country:US
Mailing Address - Phone:212-772-3722
Mailing Address - Fax:212-772-2040
Practice Address - Street 1:328 E 75TH ST OFC 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3317
Practice Address - Country:US
Practice Address - Phone:212-772-3722
Practice Address - Fax:212-772-2040
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227688174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30-0283291OtherTAX ID
NY30-0283291OtherTAX ID
NY$$$$$$$$$OtherSS #