Provider Demographics
NPI:1225284706
Name:PANAGIOTOU, DEMETRIOS NICHOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:DEMETRIOS
Middle Name:NICHOLAS
Last Name:PANAGIOTOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07653-0040
Mailing Address - Country:US
Mailing Address - Phone:201-857-2068
Mailing Address - Fax:
Practice Address - Street 1:255 W SPRING VALLEY AVE STE 200
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1444
Practice Address - Country:US
Practice Address - Phone:201-882-6088
Practice Address - Fax:201-882-6063
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08314900207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty