Provider Demographics
NPI:1912187873
Name:POULIEZOS-KARAYIANNIS, MARIA G (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:G
Last Name:POULIEZOS-KARAYIANNIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 TOWNE HOUSE VLG
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-4819
Mailing Address - Country:US
Mailing Address - Phone:631-521-6788
Mailing Address - Fax:
Practice Address - Street 1:700 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2513
Practice Address - Country:US
Practice Address - Phone:516-354-3724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0532111223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics