Provider Demographics
NPI:1477727113
Name:LIVIU CRISAN M.D. P.C.
Entity Type:Organization
Organization Name:LIVIU CRISAN M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIVIU
Authorized Official - Middle Name:CORNELIU
Authorized Official - Last Name:CRISAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-242-4322
Mailing Address - Street 1:651 LACEY RD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1403
Mailing Address - Country:US
Mailing Address - Phone:609-242-4322
Mailing Address - Fax:609-242-4324
Practice Address - Street 1:651 LACEY RD
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1403
Practice Address - Country:US
Practice Address - Phone:609-242-4322
Practice Address - Fax:609-242-4324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06156100261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF98298Medicare UPIN