Provider Demographics
NPI:1790951705
Name:STANCIU, JON (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:STANCIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 GREENPOINT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2202
Mailing Address - Country:US
Mailing Address - Phone:718-389-0100
Mailing Address - Fax:718-389-9616
Practice Address - Street 1:126 GREENPOINT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222
Practice Address - Country:US
Practice Address - Phone:718-389-0100
Practice Address - Fax:718-389-9616
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine