Provider Demographics
NPI:1639405665
Name:SPIROS MANOLIDIS MDPC
Entity Type:Organization
Organization Name:SPIROS MANOLIDIS MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPIROS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOLIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MDPC
Authorized Official - Phone:347-401-1410
Mailing Address - Street 1:16 WARREN ST
Mailing Address - Street 2:APT 2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2247
Mailing Address - Country:US
Mailing Address - Phone:347-401-1410
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-6228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty