Stavroula Theodoratos
Specialist in Brooklyn, NY. Individual provider (NPI-1).
NPI number1982252276
StatusActive
Last updated in NPPESAug 29, 2019
Details
- NPI
- 1982252276
- Entity type
- Individual (NPI-1)
- Name
- Stavroula Theodoratos
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 29, 2019
- Last updated
- Aug 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
7616 13th AveBrooklyn, NY 11228-2412
Phone 718-630-5100
Mailing address
1326 78th StBrooklyn, NY 11228-2720
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