MEDICARE: VICKI ANNE PAPADEAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	175605	NY

General Provider Information

NPI Number	:	1275619595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI ANNE PAPADEAS MD

Provider Business Mailing Address
First Line	:	505 LAGUARDIA PL
Second Line	:	L-3
City	:	NEW YORK
State	:	NY
Zip	:	10012-2001
Country	:	US
Telephone Number	:	212-505-0222
Fax Number	:	212-505-1091

Provider Business Practice Location Address
First Line	:	505 LAGUARDIA PL
Second Line	:	L-3
City	:	NEW YORK
State	:	NY
Zip	:	10012-2001
Country	:	US
Telephone Number	:	212-505-0222
Fax Number	:	212-505-1091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2006
Last Update Date	:	07/08/2007

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