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NPI Code Detail

MEDICARE: PAUL C LADOPOULOS MD PC

MEDICARE: PAUL C LADOPOULOS MD PC
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
12084P0800XPsychiatry Physician172226NY

General Provider Information

NPI Number : 1295169043
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAUL C LADOPOULOS MD PC
Provider Business Mailing Address
First Line : 3033 36TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11103-4704
Country : US
Telephone Number : 718-274-6636
Fax Number :
Provider Business Practice Location Address
First Line : 3033 36TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11103-4704
Country : US
Telephone Number : 718-274-6636
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : PAUL C LADOPOULOS
Credential : M.D.
Telephone Number : 718-274-6636
Provider Enumeration Date : 08/29/2013
Last Update Date : 08/29/2013

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Directions to “PAUL C LADOPOULOS MD PC ” Practice Location

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