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General NPI Number Information
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NPI Number | 1265846034
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Entity Type | Individual
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Provider Name | IRINA STAICU DO, MMS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 11/13/2018
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Provider Practice Location Address
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Address Line | 1420 WALNUT ST STE 904
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City | PHILADELPHIA
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State | PA
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Zip | 19102
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Country | US
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Telephone | 215-735-8052
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Fax | 215-735-5323
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Provider Business Mailing Address
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Address Line | 111 CHESTNUT ST UNIT 212
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City | CHERRY HILL
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State | NJ
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Zip | 08002-1836
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Country | US
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Telephone | 856-580-3368
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS018048
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS018048
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License Number State | PA
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