Provider Demographics
NPI:1790978096
Name:MARINESCU, LUIZIANA MANUELA (MD)
Entity Type:Individual
Prefix:
First Name:LUIZIANA MANUELA
Middle Name:
Last Name:MARINESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LUIZIANA
Other - Middle Name:M
Other - Last Name:GEGIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:315 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2869
Mailing Address - Country:US
Mailing Address - Phone:631-656-7161
Mailing Address - Fax:631-360-1546
Practice Address - Street 1:315 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2869
Practice Address - Country:US
Practice Address - Phone:631-656-7161
Practice Address - Fax:631-360-1546
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245731207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03103880Medicaid
NY03103880Medicaid