Provider Demographics
NPI:1033202429
Name:KRITIKOS, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:KRITIKOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 UNION TPKE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1759
Mailing Address - Country:US
Mailing Address - Phone:516-326-2275
Mailing Address - Fax:516-326-2251
Practice Address - Street 1:1300 UNION TPKE
Practice Address - Street 2:SUITE 105
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1759
Practice Address - Country:US
Practice Address - Phone:516-326-2275
Practice Address - Fax:516-326-2251
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY189401207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00246075Medicaid
NY00330231Medicare ID - Type Unspecified