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General NPI Number Information
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NPI Number | 1760458970
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Entity Type | Individual
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Provider Name | DR. KIMON VIOLARIS
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | COLUMBIA UNIVERSITY DEPARTMENT PEDIATRICS 3959 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-304-7250
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Fax | 212-544-1974
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Provider Business Mailing Address
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Address Line | 211 HEIGHTS RD
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2413
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Country | US
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Telephone | 201-612-6750
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 149709
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License Number State | NY
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