Healthcare Provider Details

I. General information

NPI: 1316155328
Provider Name (Legal Business Name): ANNAMARIA ZITA MOLDOVAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 S LABURNUM AVE
RICHMOND VA
23231-2713
US

IV. Provider business mailing address

4825 S LABURNUM AVE
RICHMOND VA
23231-2713
US

V. Phone/Fax

Practice location:
  • Phone: 804-236-8752
  • Fax: 804-236-8769
Mailing address:
  • Phone: 804-236-8752
  • Fax: 804-236-8759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number282000
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number332279
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD486862
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD14945
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: