Provider Demographics
NPI:1609037746
Name:CRISTOVEANU, ISAAC CLAIR
Entity Type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:CLAIR
Last Name:CRISTOVEANU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FOREST DR.
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K7L 4V1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:62 1/2 CLINTON ST
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-1302
Practice Address - Country:US
Practice Address - Phone:315-712-4280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program