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Individual

MARIA ANTONIOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3624 MARKET ST, 2ND FLOOR, PHILADELPHIA, PA 19104-2614
(215) 662-7772
Mailing address
3624 MARKET ST, 2ND FLOOR, PHILADELPHIA, PA 19104-2614
(215) 662-7772

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
MD064082L
PA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
MD064082L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001740288001
PA
01
1689600504
MEDICARE NPI
PA
Enumeration date
06/23/2006
Last updated
10/07/2013
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