Provider Demographics
NPI:1689923625
Name:GACEU, IOANA GABRIELA
Entity Type:Individual
Prefix:MISS
First Name:IOANA
Middle Name:GABRIELA
Last Name:GACEU
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 1:3418 91ST ST
Mailing Address - Street 2:APT. A63
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3663
Mailing Address - Country:US
Mailing Address - Phone:646-284-4782
Mailing Address - Fax:
Practice Address - Street 1:3418 91ST ST
Practice Address - Street 2:APT. A63
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3663
Practice Address - Country:US
Practice Address - Phone:646-284-4782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY608472121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist