Provider Demographics
NPI:1255667531
Name:IONESCU, SIMONA FLORINA (RD)
Entity type:Individual
Prefix:MRS
First Name:SIMONA
Middle Name:FLORINA
Last Name:IONESCU
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22041 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3542
Mailing Address - Country:US
Mailing Address - Phone:718-465-6444
Mailing Address - Fax:718-465-6005
Practice Address - Street 1:22041 UNION TPKE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3542
Practice Address - Country:US
Practice Address - Phone:718-465-6444
Practice Address - Fax:718-465-6005
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL925938133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered