Provider Demographics
NPI:1467447318
Name:HAMAKIOTES, DEMETRA (OD)
Entity Type:Individual
Prefix:
First Name:DEMETRA
Middle Name:
Last Name:HAMAKIOTES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 E 84TH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2000
Mailing Address - Country:US
Mailing Address - Phone:212-717-1500
Mailing Address - Fax:212-717-1482
Practice Address - Street 1:171 E 84TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2000
Practice Address - Country:US
Practice Address - Phone:212-717-1500
Practice Address - Fax:212-717-1482
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2014-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005198152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
U30114Medicare UPIN
C45781Medicare ID - Type UnspecifiedMEDICARE ID