Provider Demographics
NPI:1336111624
Name:DINULESCU, STEFAN DAN (MD)
Entity Type:Individual
Prefix:
First Name:STEFAN
Middle Name:DAN
Last Name:DINULESCU
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 1:2400 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2030
Mailing Address - Country:US
Mailing Address - Phone:516-735-7787
Mailing Address - Fax:
Practice Address - Street 1:2400 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2030
Practice Address - Country:US
Practice Address - Phone:516-735-7787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01768932Medicaid
NYG10496Medicare UPIN
NY01768932Medicaid