Basic Information
| Provider Information | |||||||||
| NPI: | 1083154322 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUMITRESCU | ||||||||
| FirstName: | ANDREEA | ||||||||
| MiddleName: | LOREDANA | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | MHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4717 39TH ST APT 3C | ||||||||
| Address2: | |||||||||
| City: | SUNNYSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111044451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9173455089 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 17810 WEXFORD TER APT 1F | ||||||||
| Address2: | |||||||||
| City: | JAMAICA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114323003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186581123 | ||||||||
| FaxNumber: | 7186587091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2017 | ||||||||
| LastUpdateDate: | 03/06/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | P05300 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.