Provider Demographics
NPI:1972635662
Name:C GENTIANA VOINESCU MD PC
Entity type:Organization
Organization Name:C GENTIANA VOINESCU MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:GENTIANA
Authorized Official - Last Name:VOINESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:505-982-4276
Mailing Address - Street 1:1650 HOSPITAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4769
Mailing Address - Country:US
Mailing Address - Phone:505-982-4276
Mailing Address - Fax:505-983-7571
Practice Address - Street 1:1650 HOSPITAL DR STE 200
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4769
Practice Address - Country:US
Practice Address - Phone:505-982-4276
Practice Address - Fax:505-983-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMH68008Medicare UPIN