Individual
GARY PANAGIOTAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
360 ESSEX ST STE 203, HACKENSACK, NJ 07601-8566
(551) 996-8867
Mailing address
360 ESSEX ST STE 203, HACKENSACK, NJ 07601-8566
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MB10528700
NJ
208VP0000X
Pain Medicine Physician
25MB10528700
NJ
208VP0014X
Interventional Pain Medicine Physician
25MB10528700
NJ
Other
Enumeration date
07/10/2014
Last updated
11/18/2021
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