Provider Demographics
NPI:1275619595
Name:PAPADEAS, VICKI ANNE (MD)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:ANNE
Last Name:PAPADEAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 LAGUARDIA PL
Mailing Address - Street 2:L-3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2001
Mailing Address - Country:US
Mailing Address - Phone:212-505-0222
Mailing Address - Fax:212-505-1091
Practice Address - Street 1:505 LAGUARDIA PL
Practice Address - Street 2:L-3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2001
Practice Address - Country:US
Practice Address - Phone:212-505-0222
Practice Address - Fax:212-505-1091
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175605208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics