Provider Demographics
NPI:1194050930
Name:GUSITA, PARASCHIVA (DMD)
Entity type:Individual
Prefix:DR
First Name:PARASCHIVA
Middle Name:
Last Name:GUSITA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:PARASCHIVA
Other - Middle Name:
Other - Last Name:PETREA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:18 12 MENAHAN STREET APT 4C
Mailing Address - Street 2:RIDGEWOOD
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1879
Mailing Address - Country:US
Mailing Address - Phone:646-233-9139
Mailing Address - Fax:
Practice Address - Street 1:37 PARK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3811
Practice Address - Country:US
Practice Address - Phone:646-233-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0553191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice