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NPI Code Detail

MEDICARE: DR. MIHAI IORDACHE, PHYSICIAN, PC

MEDICARE: DR. MIHAI IORDACHE, PHYSICIAN, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)222889NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356714497
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. MIHAI IORDACHE, PHYSICIAN, PC
Provider Business Mailing Address
First Line : 4122 42ND ST APT 4F
Second Line :
City : SUNNYSIDE
State : NY
Zip : 11104-2707
Country : US
Telephone Number : 917-863-2728
Fax Number :
Provider Business Practice Location Address
First Line : 22041 UNION TPKE
Second Line :
City : BAYSIDE
State : NY
Zip : 11364-3542
Country : US
Telephone Number : 917-863-2728
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. MIHAI MARCEL IORDACHE
Credential : M.D.
Telephone Number : 917-863-2728
Provider Enumeration Date : 11/11/2015
Last Update Date : 11/11/2015

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