Provider Demographics
NPI:1538244231
Name:IONESCU, DANITA (MD)
Entity type:Individual
Prefix:DR
First Name:DANITA
Middle Name:
Last Name:IONESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2927
Mailing Address - Country:US
Mailing Address - Phone:631-464-4545
Mailing Address - Fax:
Practice Address - Street 1:365 BROADWAY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2716
Practice Address - Country:US
Practice Address - Phone:631-464-4545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY227856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7920467OtherAETNA PPO
NY02543635Medicaid
NY112488918OtherAETNA HMO
NY159267OtherVITRA
NY3360694OtherUNITED HEALTH CARE
NYDI05329C10OtherBLUE CROSS BLUE SHIELD
NY1831760OtherCIGNA
NY5900249OtherGHI PPO
NYP3058256OtherOXFORD
NY79373OtherGHI HMO
NYDI05329C10OtherBLUE CROSS BLUE SHIELD
NY112488918OtherAETNA HMO
NY5900249OtherGHI PPO