MEDICARE: KALLIOPI PETROPOULOU MD

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	2085R0202X	Diagnostic Radiology Physician	MD418887	PA
2	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician	276263-1	NY

General Provider Information

NPI Number	:	1780692541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALLIOPI PETROPOULOU MD

Provider Business Mailing Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-1834
Country	:	US
Telephone Number	:	315-464-7029
Fax Number	:	315-464-7056

Provider Business Practice Location Address
First Line	:	750 E ADAMS ST
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13210-1834
Country	:	US
Telephone Number	:	315-464-7029
Fax Number	:	315-464-7056

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/31/2022

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