Healthcare Provider Details

I. General information

NPI: 1942246939
Provider Name (Legal Business Name): PETROS EFTHIMIOU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 E 83RD ST STE 1A
NEW YORK NY
10028-0418
US

IV. Provider business mailing address

8 E 83RD ST STE 1A
NEW YORK NY
10028-0418
US

V. Phone/Fax

Practice location:
  • Phone: 646-719-0602
  • Fax: 888-325-1761
Mailing address:
  • Phone: 646-719-0602
  • Fax: 888-325-1761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number268774
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: