Provider Demographics
NPI:1962938456
Name:CRISTINA BURICEA DPM PLLC
Entity type:Organization
Organization Name:CRISTINA BURICEA DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURICEA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:646-944-8422
Mailing Address - Street 1:166 MANILA AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5608
Mailing Address - Country:US
Mailing Address - Phone:646-944-8422
Mailing Address - Fax:
Practice Address - Street 1:166 MANILA AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5608
Practice Address - Country:US
Practice Address - Phone:646-944-8422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006858213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty