Provider Demographics
NPI:1437689833
Name:NEDELCU, SIMONA (MD, PHD)
Entity type:Individual
Prefix:
First Name:SIMONA
Middle Name:
Last Name:NEDELCU
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:SIMONA
Other - Middle Name:
Other - Last Name:TESCU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:55 LAKE AVE N
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01655-0002
Mailing Address - Country:US
Mailing Address - Phone:857-499-0050
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012823232084N0400X
FLME1684322084N0400X
TN718882084N0400X
MO20240300682084N0400X
IN01093952A2084N0400X
MA287511390200000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA271909Medicaid