Provider Demographics
NPI:1649577446
Name:MORIKIS, KALLIOPE JANE (DO)
Entity Type:Individual
Prefix:MISS
First Name:KALLIOPE
Middle Name:JANE
Last Name:MORIKIS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:KALLI
Other - Middle Name:JANE
Other - Last Name:MORIKIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:70 DUBOIS ST
Mailing Address - Street 2:HOSPITALIST DEPT
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4851
Mailing Address - Country:US
Mailing Address - Phone:845-568-2564
Mailing Address - Fax:845-568-2851
Practice Address - Street 1:70 DUBOIS ST
Practice Address - Street 2:HOSPITALIST DEPT
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4851
Practice Address - Country:US
Practice Address - Phone:845-568-2564
Practice Address - Fax:845-568-2851
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265857207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03516832Medicaid