Provider Demographics
NPI:1518250729
Name:NECULISEANU, ELVIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVIRA
Middle Name:
Last Name:NECULISEANU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1479 DAHILL RD
Mailing Address - Street 2:AP. C5
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3476
Mailing Address - Country:US
Mailing Address - Phone:646-246-8988
Mailing Address - Fax:
Practice Address - Street 1:1479 DAHILL RD
Practice Address - Street 2:AP. C5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3476
Practice Address - Country:US
Practice Address - Phone:646-246-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-20
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY288965207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program