Provider Demographics
NPI:1326137852
Name:ROSCA-SIPOT, CATALINA IOANA (MD)
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:IOANA
Last Name:ROSCA-SIPOT
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 1:4190 BEDFORD AVE APT 1J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4950
Mailing Address - Country:US
Mailing Address - Phone:718-769-1600
Mailing Address - Fax:718-769-0081
Practice Address - Street 1:4190 BEDFORD AVE APT 1J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4950
Practice Address - Country:US
Practice Address - Phone:718-769-1600
Practice Address - Fax:718-769-0081
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196379207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03374POtherHIP PRIS NUMBER
NYP887182OtherOXFORD PROVIDER NUMBER
NY2599429OtherGHI PROVIDER NUMBER
NY01558947Medicaid
NY5655731OtherAETNA PROVIDER NUMBER
NY27J291Medicare PIN
NYF91340Medicare UPIN