Provider Demographics
NPI:1225127285
Name:STANESCU, GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:
Last Name:STANESCU
Suffix:
Gender:M
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:PO BOX 74090
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-4090
Mailing Address - Country:US
Mailing Address - Phone:216-383-0100
Mailing Address - Fax:216-383-6745
Practice Address - Street 1:27155 CHARDON RD STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1166
Practice Address - Country:US
Practice Address - Phone:440-585-1200
Practice Address - Fax:440-585-1406
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35068683S207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G07391Medicare UPIN