Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 240466 | NY |
N | 111NI0900X | Internist | 240466 | NY |
Y | 207RA0401X | Internist - Addiction Medicine | 240466 | NY |
NPI | 1194866061 |
---|---|
Provider Name | Dr. Soteri Polydorou |
First Address | New York, NY 10016-9196 |
Second Address | New York, NY 10016-9196 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 17/03/2018 |