Provider Demographics
NPI:1104136688
Name:CHRISTOFOROU, MARIA (COTA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:CHRISTOFOROU
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E 88TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-4909
Mailing Address - Country:US
Mailing Address - Phone:212-534-3656
Mailing Address - Fax:212-534-4141
Practice Address - Street 1:316 E 88TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4909
Practice Address - Country:US
Practice Address - Phone:212-534-3656
Practice Address - Fax:212-534-4141
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0049231174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator