Provider Demographics
NPI:1033621107
Name:KEKATOS, PARISKEVI (DPM)
Entity Type:Individual
Prefix:DR
First Name:PARISKEVI
Middle Name:
Last Name:KEKATOS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SPINNING WHEEL LN
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 SPINNING WHEEL LN
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5010
Practice Address - Country:US
Practice Address - Phone:516-477-9402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-30
Last Update Date:2020-06-16
Deactivation Date:2017-10-30
Deactivation Code:
Reactivation Date:2018-04-27
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY007070213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program