Basic Information
Provider Information | |||||||||
NPI: | 1558459511 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | POPESCU | ||||||||
FirstName: | ANCA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 151 FRIES MILL RD STE 102 | ||||||||
Address2: |   | ||||||||
City: | TURNERSVILLE | ||||||||
State: | NJ | ||||||||
PostalCode: | 080122056 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563526660 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 435 HURFFVILLE CROSS KEYS RD | ||||||||
Address2: |   | ||||||||
City: | TURNERSVILLE | ||||||||
State: | NJ | ||||||||
PostalCode: | 080122453 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8562185634 | ||||||||
FaxNumber: | 8562185664 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/11/2006 | ||||||||
LastUpdateDate: | 02/10/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/10/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | MA07965500 | NJ | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
ID | Type | State | Issuer | Description | 1121890 | 01 |   | AETNA | OTHER | 2324831 | 01 |   | UNITED HEALTHCARE | OTHER | P00289642 | 01 |   | RR MEDICARE | OTHER | P3663583 | 01 |   | OXFORD | OTHER | 0009181 | 05 | NJ |   | MEDICAID | 1121894 | 01 |   | AETNA | OTHER | 2728293000 | 01 |   | AMERIHEALTH, KEYSTONE, IBC | OTHER | 60021991 | 01 |   | HORIZON NJ HEALTH | OTHER | 010007778 | 01 |   | AMERICHOICE | OTHER | 8113967 | 01 |   | CIGNA | OTHER | 3K6144 | 01 |   | HEALTHNET | OTHER | 42072 | 01 |   | UNIVERSITY HEALTHPLAN | OTHER |