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General NPI Number Information
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NPI Number | 1386639268
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Entity Type | Individual
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Provider Name | MARINA RUXANDRA IONITA MD
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Gender | Female
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 520 SAYBROOK RD
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City | MIDDLETOWN
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State | CT
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Zip | 06457-4700
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Country | US
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Telephone | 860-344-1801
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Fax | 860-358-8657
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Provider Business Mailing Address
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Address Line | 28 CRESCENT ST SUITE #A101
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3654
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Country | US
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Telephone | 860-358-4820
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Fax | 860-358-8661
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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 | 042617
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 042617
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License Number State | CT
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