Provider Demographics
NPI:1700015559
Name:KARIPIDIS POURIA, MARIA V (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:V
Last Name:KARIPIDIS POURIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7255 STATE ROUTE 96
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9009
Mailing Address - Country:US
Mailing Address - Phone:585-244-1506
Mailing Address - Fax:
Practice Address - Street 1:7255 STATE ROUTE 96
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9009
Practice Address - Country:US
Practice Address - Phone:585-244-1506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280861-1207RS0010X, 2080S0010X
IL125057017208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine