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Individual

DR. GEORGIA PANAGOPOULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
530 EAST 72ND STREET, APT 7B, NEW YORK, NY 10021-4844
(212) 628-9039
Mailing address
530 E 72ND ST APT 7B, NEW YORK, NY 10021-4844
(212) 628-9039

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009595
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S09595-0
WORKERS COMPENSATION AUTHORIZATION NUMBER
NY
Enumeration date
10/06/2017
Last updated
10/06/2017
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