Provider Demographics
NPI:1912116377
Name:MUNCACIU, SORIN TITUS (CSA)
Entity Type:Individual
Prefix:MR
First Name:SORIN
Middle Name:TITUS
Last Name:MUNCACIU
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21301 HIGHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7605
Mailing Address - Country:US
Mailing Address - Phone:703-433-2253
Mailing Address - Fax:703-433-2253
Practice Address - Street 1:21301 HIGHWOOD CT
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7605
Practice Address - Country:US
Practice Address - Phone:703-433-2253
Practice Address - Fax:703-433-2253
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2301246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2301OtherCERTIFIED SURGICAL ASSIST