Provider Demographics
NPI:1861585945
Name:STANESCU, ROXANA (MD)
Entity type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:STANESCU
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:PO BOX 8792
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8792
Mailing Address - Country:US
Mailing Address - Phone:440-944-4070
Mailing Address - Fax:440-944-9162
Practice Address - Street 1:27155 CHARDON RD STE 205
Practice Address - Street 2:
Practice Address - City:RICHMOND HTS
Practice Address - State:OH
Practice Address - Zip Code:44143-1166
Practice Address - Country:US
Practice Address - Phone:440-944-4070
Practice Address - Fax:440-944-9162
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-074838207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2142907Medicaid
OH0877638Medicare PIN