Provider Demographics
NPI:1881832780
Name:KORENIS, PANAGIOTA (MD)
Entity Type:Individual
Prefix:DR
First Name:PANAGIOTA
Middle Name:
Last Name:KORENIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1276 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-3402
Mailing Address - Country:US
Mailing Address - Phone:914-426-5127
Mailing Address - Fax:718-901-8656
Practice Address - Street 1:1879 MADISON AVE
Practice Address - Street 2:NORTH GENERAL HOSPITAL
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:212-423-4646
Practice Address - Fax:212-423-4095
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYAH1855697562084P0800X
NY2664052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY266405OtherNYS MEDICAL LICENSE