Provider Demographics
NPI:1801958962
Name:SERGIOU, HARRY GEORGE (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:GEORGE
Last Name:SERGIOU
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 1:554 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2745
Mailing Address - Country:US
Mailing Address - Phone:718-625-5591
Mailing Address - Fax:718-625-1610
Practice Address - Street 1:554 HENRY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-2745
Practice Address - Country:US
Practice Address - Phone:718-625-5591
Practice Address - Fax:718-625-1610
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153814208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics