Provider Demographics
NPI:1538113949
Name:VLADUTIU, MIHAELA I (MD)
Entity Type:Individual
Prefix:DR
First Name:MIHAELA
Middle Name:I
Last Name:VLADUTIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MIHAELA
Other - Middle Name:I
Other - Last Name:GALICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:60 GRAMERCY PARK N
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5423
Mailing Address - Country:US
Mailing Address - Phone:212-254-1220
Mailing Address - Fax:212-254-1387
Practice Address - Street 1:60 GRAMERCY PARK N
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5423
Practice Address - Country:US
Practice Address - Phone:212-254-1220
Practice Address - Fax:212-254-1387
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57N891207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01947846Medicaid
NY57N891Medicare PIN
NYG96025Medicare UPIN