Provider Demographics
NPI:1619144052
Name:BUHAESCU, IRINA (MD)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:BUHAESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1 ESSEX CENTER DRIVE
Mailing Address - Street 2:LAHEY NORTHSHORE
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2901
Mailing Address - Country:US
Mailing Address - Phone:978-538-4760
Mailing Address - Fax:978-538-4832
Practice Address - Street 1:1 ESSEX CENTER DRIVE
Practice Address - Street 2:LAHEY NORTHSHORE
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2901
Practice Address - Country:US
Practice Address - Phone:978-538-4760
Practice Address - Fax:978-538-4832
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2011-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA228897207R00000X
MA238860207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110089348AMedicaid
MA002284102Medicare PIN
MA110089348AMedicaid