Provider Demographics
NPI:1053398685
Name:VLADUTIU, POMPEIU VLAD (MD)
Entity type:Individual
Prefix:
First Name:POMPEIU
Middle Name:VLAD
Last Name:VLADUTIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 CRABAPPLE RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1700
Mailing Address - Country:US
Mailing Address - Phone:516-365-9626
Mailing Address - Fax:
Practice Address - Street 1:3120 54TH ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-1530
Practice Address - Country:US
Practice Address - Phone:516-320-0444
Practice Address - Fax:516-365-9002
Is Sole Proprietor?:No
Enumeration Date:2005-12-24
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237659207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02687070Medicaid