Basic Information
Provider Information
NPI: 1821748013
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: IONESCU
FirstName: RUXANDRA
MiddleName: MONICA
NamePrefix: MRS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 29675 NOTTINGHAM CIR
Address2:  
City: LIVONIA
State: MI
PostalCode: 481522131
CountryCode: US
TelephoneNumber: 2482559543
FaxNumber:  
Practice Location
Address1: 6245 INKSTER RD
Address2:  
City: GARDEN CITY
State: MI
PostalCode: 481354001
CountryCode: US
TelephoneNumber: 7344583300
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/28/2022
LastUpdateDate: 03/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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