Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 163705 | NY |
NPI | 1003855610 |
---|---|
Provider Name | George Nicholas Coritsidis |
First Address | Elmhurst, NY 11373-1329 |
Second Address | Elmhurst, NY 11373-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 16/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01477114 | (05) | NY |
5324UW | (02) | NY |
E87440 | (02) | NY |