Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | 000085 | NY |
Y | 1223P0300X | Periodontist | RFD000047 | PA |
NPI | 1043724479 |
---|---|
Provider Name | Dr. Ioana Chesnoiu Matei |
First Address | New York, NY 10032-3725 |
Second Address | New York, NY 10032-3725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2017 |
Last Update Date | 06/12/2021 |