Individual
DR. KOSTANTINOS PANTELIS POULIKIDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
80 JAMES ST, EDISON, NJ 08820-3938
(732) 635-9300
Mailing address
80 JAMES ST, EDISON, NJ 08820-3938
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036.145990
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
25MA11659600
NJ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
68699
CT
390200000X
Student in an Organized Health Care Education/Training Program
AS2383278 - 0842
CT
Other
Enumeration date
04/18/2013
Last updated
01/22/2026
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