Provider Demographics
NPI:1790149177
Name:PANAGIOTOU, POLLYTIA IRENE
Entity Type:Individual
Prefix:DR
First Name:POLLYTIA
Middle Name:IRENE
Last Name:PANAGIOTOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 COMMACK RD UNIT 206
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-5022
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2628
Practice Address - Street 1:43 RADIO AVE
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-3125
Practice Address - Country:US
Practice Address - Phone:631-821-8911
Practice Address - Fax:631-821-8912
Is Sole Proprietor?:No
Enumeration Date:2016-04-11
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306758207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine