MEDICARE: ANCA MARILENA STUPARU NP

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
1	363LF0000X	Family Nurse Practitioner	F339212-1	NY

General Provider Information

NPI Number	:	1487048450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANCA MARILENA STUPARU NP

Provider Business Mailing Address
First Line	:	10524 67TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2162
Country	:	US
Telephone Number	:	347-418-1812
Fax Number	:

Provider Business Practice Location Address
First Line	:	10524 67TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2162
Country	:	US
Telephone Number	:	347-418-1812
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2015
Last Update Date	:	03/26/2015

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