MEDICARE: CAMELIA E GANEA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	221575	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821057266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMELIA E GANEA MD

Provider Business Mailing Address
First Line	:	3777 INDEPENDENCE AVE
Second Line	:	APT 15F
City	:	BRONX
State	:	NY
Zip	:	10463-1409
Country	:	US
Telephone Number	:	718-707-3434
Fax Number	:	718-707-3435

Provider Business Practice Location Address
First Line	:	4701 QUEENS BLVD
Second Line	:	SUITE 303
City	:	SUNNYSIDE
State	:	NY
Zip	:	11104-1600
Country	:	US
Telephone Number	:	718-707-3434
Fax Number	:	718-707-3435

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	06/03/2008

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Directions to “ CAMELIA E GANEA MD” Practice Location

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