Provider Demographics
NPI:1457314973
Name:KIROU, KYRIAKOS A (MD)
Entity Type:Individual
Prefix:DR
First Name:KYRIAKOS
Middle Name:A
Last Name:KIROU
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 1:535 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4872
Mailing Address - Country:US
Mailing Address - Phone:212-606-1728
Mailing Address - Fax:212-606-1012
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:212-606-1728
Practice Address - Fax:212-606-1012
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2286881174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02502427Medicaid
NYP00195537OtherRAILROAD MEDICARE
NYP00195537OtherRAILROAD MEDICARE
NY02502427Medicaid