Individual
MARY ANDREA PANOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
82 2ND ST, GARDEN CITY, NY 11530-4416
(516) 996-5574
Mailing address
82 2ND ST, GARDEN CITY, NY 11530-4416
(516) 996-5574
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F305486-1
NY
Other
Enumeration date
09/29/2010
Last updated
10/11/2012
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