Provider Demographics
NPI:1619120375
Name:MOLDOVAN, MARIA RAMONA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:RAMONA
Last Name:MOLDOVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28B INDIAN ROCK
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4907
Mailing Address - Country:US
Mailing Address - Phone:845-368-2180
Mailing Address - Fax:845-368-2187
Practice Address - Street 1:28B INDIAN ROCK
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:NY
Practice Address - Zip Code:10901-4907
Practice Address - Country:US
Practice Address - Phone:845-368-2180
Practice Address - Fax:845-623-6556
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027305174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist