1093949224 NPI number — ANDREI MIHNEA DOBRESCU M.D.

Table of content: AMY LYNN MARTIN M.D. (NPI 1619036670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093949224 NPI number — ANDREI MIHNEA DOBRESCU M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOBRESCU
Provider First Name:
ANDREI
Provider Middle Name:
MIHNEA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093949224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
629 CRANBURY RD FL 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08816-4096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-390-7750
Provider Business Mailing Address Fax Number:
732-390-7725

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 US HIGHWAY 22 EAST, 3RD FL.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEWATER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08807-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-390-7750
Provider Business Practice Location Address Fax Number:
908-927-8706
Provider Enumeration Date:
05/01/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  240296 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 240296 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 25MA08567700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1790396281 . This is a "TITAN HEALTH GROUP NPI#" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".