Healthcare Provider Details

I. General information

NPI: 1992023873
Provider Name (Legal Business Name): NICHOLAS A GEORGIOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 FIRST STREET WINTHROP-UNIVERSITY HOSPITAL (RADIOLOGY DEPARTMENT)
MINEOLA NY
11501
US

IV. Provider business mailing address

190 MAIN PARKWAY WEST
PLAINVIEW NY
11803
US

V. Phone/Fax

Practice location:
  • Phone: 516-633-9534
  • Fax:
Mailing address:
  • Phone: 516-633-9534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number257304
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number257304
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: