Provider Demographics
NPI:1467530667
Name:NICOLAESCU, VIOREL (MD)
Entity Type:Individual
Prefix:DR
First Name:VIOREL
Middle Name:
Last Name:NICOLAESCU
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 1:305 EAST 24TH STREET
Mailing Address - Street 2:STE 9C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-6401
Mailing Address - Country:US
Mailing Address - Phone:212-353-8552
Mailing Address - Fax:212-475-8718
Practice Address - Street 1:201 EAST 21ST ST
Practice Address - Street 2:STE 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6401
Practice Address - Country:US
Practice Address - Phone:212-353-8552
Practice Address - Fax:212-475-8718
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00977239Medicaid
NYA63846Medicare UPIN
NY69D861Medicare ID - Type Unspecified