=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265559553
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAUDIU-GILY IONESCU-TAJTI M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2007
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 DARTMOUTH COLLEGE HWY
-----------------------------------------------------
City | LYME
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03768-3236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-650-1070
-----------------------------------------------------
Fax | 603-640-1228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 810
-----------------------------------------------------
City | HANOVER
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03755-0810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-308-1467
-----------------------------------------------------
Fax | 509-527-8010
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD60072805
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 33116
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------