Provider Demographics
NPI:1114239654
Name:KARAGEORGIOU, PANAGIOTIS PANOS (OD)
Entity Type:Individual
Prefix:DR
First Name:PANAGIOTIS
Middle Name:PANOS
Last Name:KARAGEORGIOU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HENRY ST
Mailing Address - Street 2:3B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6959
Mailing Address - Country:US
Mailing Address - Phone:646-884-0049
Mailing Address - Fax:
Practice Address - Street 1:123A 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1802
Practice Address - Country:US
Practice Address - Phone:212-627-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY56007599152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist