Provider Demographics
NPI:1629040423
Name:FEURDEAN, MIRELA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRELA
Middle Name:C
Last Name:FEURDEAN
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 1:3 FARRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-1307
Mailing Address - Country:US
Mailing Address - Phone:908-598-7950
Mailing Address - Fax:908-686-1163
Practice Address - Street 1:3 FARRINGTON ST
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1307
Practice Address - Country:US
Practice Address - Phone:908-598-7950
Practice Address - Fax:908-686-1163
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235929207R00000X
NJ25MA 08403300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02673687Medicaid
NY02673687Medicaid
I44834Medicare UPIN