Healthcare Provider Details

I. General information

NPI: 1063414910
Provider Name (Legal Business Name): MARIA BAIULESCU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 LITCHFIELD STREET CHARLOTTE HUNGERFORD HOSP MSO
TORRINGTON CT
06790
US

IV. Provider business mailing address

540 LITCHFIELD STREET CHARLOTTE HUNGERFORD HOSP MSO
TORRINGTON CT
06790
US

V. Phone/Fax

Practice location:
  • Phone: 860-796-6340
  • Fax: 860-482-8627
Mailing address:
  • Phone: 860-796-6340
  • Fax: 860-482-8627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number014573
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: