Healthcare Provider Details

I. General information

NPI: 1629232129
Provider Name (Legal Business Name): GEORGE C. CHRISTOLIAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 05/18/2020
Certification Date: 05/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORT WASHINGTON AVE # HP-199
NEW YORK NY
10032-3722
US

IV. Provider business mailing address

525 E 68TH ST BAKER BLDG. 16TH FLOOR
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-3535
  • Fax: 212-342-1470
Mailing address:
  • Phone: 212-746-1500
  • Fax: 212-746-8303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number265584-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number265584
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: