Provider Demographics
NPI:1902845977
Name:GEANOPULOS, STEVEN G (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:GEANOPULOS
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 1:812 W 181ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4543
Mailing Address - Country:US
Mailing Address - Phone:212-928-3300
Mailing Address - Fax:212-740-2005
Practice Address - Street 1:812 W 181ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-4543
Practice Address - Country:US
Practice Address - Phone:212-928-3300
Practice Address - Fax:212-740-2005
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSG0X885210Medicare PIN
NYU65664Medicare UPIN