Provider Demographics
NPI:1225357056
Name:GONCIULEA, ANDA RALUCA (MD)
Entity Type:Individual
Prefix:
First Name:ANDA
Middle Name:RALUCA
Last Name:GONCIULEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:806 W DIAMOND AVE
Mailing Address - Street 2:310
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1415
Mailing Address - Country:US
Mailing Address - Phone:301-977-0056
Mailing Address - Fax:301-977-5151
Practice Address - Street 1:1152 KINGS HIGHWAY CUTOFF
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5271
Practice Address - Country:US
Practice Address - Phone:203-256-5500
Practice Address - Fax:203-254-2235
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0081341207RE0101X
CT61511207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0081341OtherMD LICENSE