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General NPI Number Information
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NPI Number | 1356714497
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Entity Type | Organization
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Legal Business Name | DR. MIHAI IORDACHE, PHYSICIAN, PC
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 22041 UNION TPKE
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City | BAYSIDE
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State | NY
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Zip | 11364-3542
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Country | US
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Telephone | 917-863-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 4122 42ND ST APT 4F
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City | SUNNYSIDE
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State | NY
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Zip | 11104-2707
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Country | US
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Telephone | 917-863-2728
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MIHAI MARCEL IORDACHE
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Credential | M.D.
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Telephone | 917-863-2728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 222889
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License Number State | NY
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