Provider Demographics
NPI:1598794760
Name:VARTOLOMEI, ROXANA MIHAELA (MD)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:MIHAELA
Last Name:VARTOLOMEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROXANA
Other - Middle Name:MIHAELA
Other - Last Name:STOICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4401 FRANCIS LEWIS BLVD
Mailing Address - Street 2:SUITE L3A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3028
Mailing Address - Country:US
Mailing Address - Phone:718-423-3355
Mailing Address - Fax:718-423-3721
Practice Address - Street 1:4401 FRANCIS LEWIS BLVD
Practice Address - Street 2:SUITE L3A
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3028
Practice Address - Country:US
Practice Address - Phone:718-423-3355
Practice Address - Fax:718-423-3721
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230513207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02510314Medicaid
NYI03638Medicare UPIN
NY02510314Medicaid
NYA400091230Medicare PIN