Provider Demographics
NPI:1649484775
Name:SECAREANU, CRISTIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CRISTIAN
Middle Name:
Last Name:SECAREANU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5903 ROOSEVELT AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3546
Mailing Address - Country:US
Mailing Address - Phone:718-651-7700
Mailing Address - Fax:
Practice Address - Street 1:5903 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3546
Practice Address - Country:US
Practice Address - Phone:718-651-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA052507-01171100000X
NY0525071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No171100000XOther Service ProvidersAcupuncturist