Healthcare Provider Details

I. General information

NPI: 1124680715
Provider Name (Legal Business Name): ANCUTA ANDONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDCEN UNIT 33100
LANDSTUHL GERMANY
09180
DE

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDCEN UNIT 33100
LANDSTUHL GERMANY
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 314-590-2103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberC012256
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: