Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 268352 | NY |
NPI | 1033462684 |
---|---|
Provider Name | Varvara Alexiadis |
First Address | Rockville Centre, NY 11570-5254 |
Second Address | Rockville Centre, NY 11570-5254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2012 |
Last Update Date | 24/06/2013 |