Provider Demographics
NPI:1427406008
Name:PANTOPOULOS, NICOLE (MS ED/SPECIAL EDU)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:PANTOPOULOS
Suffix:
Gender:F
Credentials:MS ED/SPECIAL EDU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-2105
Mailing Address - Country:US
Mailing Address - Phone:646-379-1778
Mailing Address - Fax:
Practice Address - Street 1:845 E 96TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-2105
Practice Address - Country:US
Practice Address - Phone:646-379-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator