1932132479 NPI number — CRISTIAN P VILCU M.D.

Table of content: CRISTIAN P VILCU M.D. (NPI 1932132479)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932132479 NPI number — CRISTIAN P VILCU M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VILCU
Provider First Name:
CRISTIAN
Provider Middle Name:
P
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:
1932132479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/18/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 AURORA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21613-1903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-228-9515
Provider Business Mailing Address Fax Number:
410-228-3009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 BYRN ST
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21613-1917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-221-7770
Provider Business Practice Location Address Fax Number:
410-221-7863
Provider Enumeration Date:
07/08/2006

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: 207RE0101X , with the licence number:  A87208 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: E6360013 . This is a "FEDERAL BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 89229501 . This is a "CAREFIRST BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 412541000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com