Provider Demographics
NPI:1336282847
Name:MADALINA M. MANEA DDS, P.C.
Entity Type:Organization
Organization Name:MADALINA M. MANEA DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MADALINA
Authorized Official - Middle Name:MARINA
Authorized Official - Last Name:MANEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-750-3988
Mailing Address - Street 1:405 LEXINGTON AVE
Mailing Address - Street 2:TOWER SUITE 6900
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10174-0002
Mailing Address - Country:US
Mailing Address - Phone:212-750-3988
Mailing Address - Fax:212-750-3988
Practice Address - Street 1:405 LEXINGTON AVE
Practice Address - Street 2:TOWER SUITE 6900
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10174-0002
Practice Address - Country:US
Practice Address - Phone:212-750-3988
Practice Address - Fax:212-750-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY510001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02511053Medicaid