Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 129054 | NY |
NPI | 1104062553 |
---|---|
Provider Name | Dr. Mihai Dimancescu |
First Address | Rockville Centre, NY 11570-4821 |
Second Address | Rockville Centre, NY 11570-4821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2009 |
Last Update Date | 06/01/2009 |