Provider Demographics
NPI:1194322800
Name:POPESCU, CONSTANTIN RAZVAN (NP)
Entity type:Individual
Prefix:
First Name:CONSTANTIN
Middle Name:RAZVAN
Last Name:POPESCU
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 SUMMER VIEW DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-2001
Mailing Address - Country:US
Mailing Address - Phone:203-984-2957
Mailing Address - Fax:
Practice Address - Street 1:46 SUMMER VIEW DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468-2001
Practice Address - Country:US
Practice Address - Phone:203-984-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT9129363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care