Provider Demographics
NPI:1942246939
Name:EFTHIMIOU, PETROS (MD)
Entity Type:Individual
Prefix:
First Name:PETROS
Middle Name:
Last Name:EFTHIMIOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PARK AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0913
Mailing Address - Country:US
Mailing Address - Phone:646-719-0602
Mailing Address - Fax:888-325-1761
Practice Address - Street 1:1020 PARK AVE FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0913
Practice Address - Country:US
Practice Address - Phone:646-719-0602
Practice Address - Fax:888-325-1761
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY268774207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I25358Medicare UPIN