Provider Demographics
NPI:1972864262
Name:NEDELCU, ROXANA IOANA (BEHAVIOR ANALYST)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:IOANA
Last Name:NEDELCU
Suffix:
Gender:F
Credentials:BEHAVIOR ANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6914 GROTON ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5150
Mailing Address - Country:US
Mailing Address - Phone:347-707-6610
Mailing Address - Fax:
Practice Address - Street 1:6914 GROTON ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5150
Practice Address - Country:US
Practice Address - Phone:347-707-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-03
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1106930103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst