Provider Demographics
NPI:1134516990
Name:PANAGIOTIS ZENETOS PHYSICIAN PC
Entity Type:Organization
Organization Name:PANAGIOTIS ZENETOS PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PANAGIOTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENETOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-572-6136
Mailing Address - Street 1:21633 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2611
Mailing Address - Country:US
Mailing Address - Phone:917-572-6136
Mailing Address - Fax:718-313-0436
Practice Address - Street 1:21633 27TH AVE
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2611
Practice Address - Country:US
Practice Address - Phone:917-572-6136
Practice Address - Fax:718-313-0436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235075208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty