Provider Demographics
NPI:1538449145
Name:SALCEANU, CARMEN ILEANA
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:ILEANA
Last Name:SALCEANU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 JOHNSTON ST
Mailing Address - Street 2:301
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3276
Mailing Address - Country:US
Mailing Address - Phone:337-234-0197
Mailing Address - Fax:
Practice Address - Street 1:2517 KALISTE SALOOM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6811
Practice Address - Country:US
Practice Address - Phone:337-216-9187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA46577183500000X
LA019783183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist