Individual
DR. NICHOLAS D. PANAGIOTOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D, PH.D., M.S.
Contact information
Practice address
385 SOUTH MAPLE AVE, SUITE 107, RIDGEWOOD, NJ 07450
(201) 447-3690
(201) 447-3691
Mailing address
P.O. BOX 115, RIDGEWOOD, NJ 07451-0115
(201) 447-3690
(201) 447-3691
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MAO7320300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8751102
—
NJ
Enumeration date
06/08/2006
Last updated
10/10/2013
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