Provider Demographics
NPI:1831209881
Name:NICOLESCU, ADA (MD)
Entity type:Individual
Prefix:DR
First Name:ADA
Middle Name:
Last Name:NICOLESCU
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 1:20 E 68TH ST
Mailing Address - Street 2:STE 206
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-5867
Mailing Address - Country:US
Mailing Address - Phone:212-486-9787
Mailing Address - Fax:
Practice Address - Street 1:20 E 68TH ST
Practice Address - Street 2:STE 206
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-5867
Practice Address - Country:US
Practice Address - Phone:212-879-9787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1315982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY349741Medicare ID - Type Unspecified