Provider Demographics
NPI:1265559553
Name:IONESCU-TAJTI, CLAUDIU-GILY (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDIU-GILY
Middle Name:
Last Name:IONESCU-TAJTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GILY
Other - Middle Name:
Other - Last Name:IONESCU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03755-0810
Mailing Address - Country:US
Mailing Address - Phone:603-308-1467
Mailing Address - Fax:509-527-8010
Practice Address - Street 1:204 DARTMOUTH COLLEGE HWY
Practice Address - Street 2:
Practice Address - City:LYME
Practice Address - State:NH
Practice Address - Zip Code:03768-3236
Practice Address - Country:US
Practice Address - Phone:603-650-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60072805207R00000X
NH33116207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2008840Medicaid
WA2008840Medicaid