MEDICARE: DR. DEMETRIOS NICHOLAS PANAGIOTOU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	25MA08314900	NJ

General Provider Information

NPI Number	:	1225284706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEMETRIOS NICHOLAS PANAGIOTOU M.D.

Provider Business Mailing Address
First Line	:	PO BOX 40
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07653-0040
Country	:	US
Telephone Number	:	201-857-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 W SPRING VALLEY AVE STE 200
Second Line	:
City	:	MAYWOOD
State	:	NJ
Zip	:	07607-1444
Country	:	US
Telephone Number	:	201-882-6088
Fax Number	:	201-882-6063

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	01/24/2019

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