Basic Information
Provider Information | |||||||||
NPI: | 1790910966 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | DOBRESCU | ||||||||
FirstName: | DELIA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | COTIGA | ||||||||
OtherFirstName: | DELIA | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 8000 | ||||||||
Address2: | DEPT 596 | ||||||||
City: | BUFFALO | ||||||||
State: | NY | ||||||||
PostalCode: | 142670002 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7326711697 | ||||||||
FaxNumber: | 7326152439 | ||||||||
Practice Location | |||||||||
Address1: | 1270 HIGHWAY 35 | ||||||||
Address2: |   | ||||||||
City: | MIDDLETOWN | ||||||||
State: | NJ | ||||||||
PostalCode: | 077482014 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7326153900 | ||||||||
FaxNumber: | 7326150865 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/18/2009 | ||||||||
LastUpdateDate: | 02/14/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 25MA08583200 | NJ | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | 25MA08583200 | NJ | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
ID | Type | State | Issuer | Description | 0277461 | 05 | NJ |   | MEDICAID | 155743DE4 | 01 | NJ | MEDICARE | OTHER |