Provider Demographics
NPI:1821139882
Name:BEREANU, ANCA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANCA
Middle Name:
Last Name:BEREANU
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 1:401 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:215-579-8292
Practice Address - Street 1:401 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5526
Practice Address - Country:US
Practice Address - Phone:215-504-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD040677E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011488460002Medicaid
PA011488460002Medicaid
PAN19067090OtherQUEST
PA1006418OtherKEYSTONE MERCY HEALTH PLA
PA0365478000OtherINDEPENDENCE BLUE CROSS
PAMD040677EOtherMEDICAL LICENSE
PABB7554808OtherDEA - PA
PAMD040677EOtherMEDICAL LICENSE
PA1006418OtherKEYSTONE MERCY HEALTH PLA
PA548057Medicare ID - Type UnspecifiedMEDICARE