Provider Demographics
NPI:1184784597
Name:TODIRASCU, ROXANA L (MD)
Entity type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:L
Last Name:TODIRASCU
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 1:244 5TH AVE # 2515
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7604
Mailing Address - Country:US
Mailing Address - Phone:212-742-8000
Mailing Address - Fax:212-742-1557
Practice Address - Street 1:244 5TH AVE # 2515
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7604
Practice Address - Country:US
Practice Address - Phone:212-742-8000
Practice Address - Fax:212-742-1557
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217191208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04416Medicare ID - Type Unspecified