Provider Demographics
NPI:1699032672
Name:PAVELESCU, RAZVAN ANDREI (DPM)
Entity Type:Individual
Prefix:DR
First Name:RAZVAN
Middle Name:ANDREI
Last Name:PAVELESCU
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:R
Other - Last Name:PAVELESCU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:22 W 85TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4535
Mailing Address - Country:US
Mailing Address - Phone:734-837-2180
Mailing Address - Fax:
Practice Address - Street 1:14 PENN PLZ STE 1005
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10122-1005
Practice Address - Country:US
Practice Address - Phone:212-564-7644
Practice Address - Fax:212-564-7645
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4329213ES0103X
NY006786213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04914985Medicaid