Provider Demographics
NPI:1851470546
Name:GEORGIOU, ANDREAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:
Last Name:GEORGIOU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PELL MELL DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1624
Mailing Address - Country:US
Mailing Address - Phone:203-778-1112
Mailing Address - Fax:203-778-9888
Practice Address - Street 1:56 PADANARAM RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-3704
Practice Address - Country:US
Practice Address - Phone:203-778-1112
Practice Address - Fax:203-778-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001231111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT050001231CT02OtherANTHEM