Healthcare Provider Details

I. General information

NPI: 1821358219
Provider Name (Legal Business Name): ROXANA CUCULESCU-BEGG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 FIRST AVE
NYC NY
10017
US

IV. Provider business mailing address

242 WARREN AVE
FORT LEE NJ
07024
US

V. Phone/Fax

Practice location:
  • Phone: 212-949-6105
  • Fax:
Mailing address:
  • Phone: 201-406-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number044247-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: