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General NPI Number Information
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NPI Number | 1861763229
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Entity Type | Organization
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Legal Business Name | PAUL KRITIKOS MD FACS PC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 1300 UNION TPKE STE 105
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1759
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Country | US
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Telephone | 516-326-2275
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Fax | 516-326-2251
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Provider Business Mailing Address
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Address Line | 1300 UNION TPKE STE 105
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1759
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Country | US
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Telephone | 516-326-2275
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Fax | 516-326-2251
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAUL KRITIKOS
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Credential | MD
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Telephone | 516-326-2275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 189401
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License Number State | NY
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