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Individual

MARIA THEODOULOU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
400 PATROON CREEK BLVD, SUITE 1, ALBANY, NY 12206-5013
(518) 489-0044
(518) 489-3591
Mailing address
400 PATROON CREEK BLVD, SUITE 1, ALBANY, NY 12206-5013
(518) 489-0044
(518) 489-3591

Taxonomy

Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
183499
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03577891
NY
Enumeration date
10/05/2006
Last updated
03/20/2019
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