Provider Demographics
NPI:1174146138
Name:SETIAWAN, CLAUDIA ANGELA (MD)
Entity type:Individual
Prefix:MS
First Name:CLAUDIA
Middle Name:ANGELA
Last Name:SETIAWAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 LEXON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1802
Mailing Address - Country:US
Mailing Address - Phone:212-939-1406
Mailing Address - Fax:
Practice Address - Street 1:506 LEXON AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1802
Practice Address - Country:US
Practice Address - Phone:212-939-1406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2022-02-22
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-02-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program