Provider Demographics
NPI:1366691479
Name:DRACEA, CRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:DRACEA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 BELLE MEADE RD, SUITE 1
Mailing Address - Street 2:SUFFOLK PLASTIC SURGEONS, PC
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733
Mailing Address - Country:US
Mailing Address - Phone:631-751-4400
Mailing Address - Fax:631-689-2375
Practice Address - Street 1:179 BELLE MEADE RD, SUITE 1
Practice Address - Street 2:SUFFOLK PLASTIC SURGEONS, PC
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733
Practice Address - Country:US
Practice Address - Phone:631-751-4400
Practice Address - Fax:631-689-2375
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY262328208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11-3193312OtherTIN