Healthcare Provider Details

I. General information

NPI: 1972923316
Provider Name (Legal Business Name): RAZVAN HUREZEANU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 12/17/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 N COUNTRY RD
PORT JEFFERSON NY
11777-2119
US

IV. Provider business mailing address

4710 SW 10TH ST
PLANTATION FL
33317-4802
US

V. Phone/Fax

Practice location:
  • Phone: 954-648-2873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: