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General NPI Number Information
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NPI Number | 1134516990
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Entity Type | Organization
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Legal Business Name | PANAGIOTIS ZENETOS PHYSICIAN PC
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 21633 27TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11360-2611
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Country | US
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Telephone | 917-572-6136
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Fax | 718-313-0436
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Provider Business Mailing Address
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Address Line | 21633 27TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11360-2611
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Country | US
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Telephone | 917-572-6136
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Fax | 718-313-0436
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Authorized Official
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Title or Position | PRESIDENT
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Name | PANAGIOTIS ZENETOS
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Credential | M.D.
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Telephone | 917-572-6136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 235075
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License Number State | NY
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