Provider Demographics
NPI:1316166440
Name:KARAKIZIS, DEMETRIOS (DC)
Entity type:Individual
Prefix:MR
First Name:DEMETRIOS
Middle Name:
Last Name:KARAKIZIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8770 173 STREET
Mailing Address - Street 2:#1G
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4666
Mailing Address - Country:US
Mailing Address - Phone:718-658-2571
Mailing Address - Fax:
Practice Address - Street 1:2287 NOSTRAND AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210
Practice Address - Country:US
Practice Address - Phone:718-677-7966
Practice Address - Fax:718-677-7948
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007685111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
C0768538OtherNYS WORKERS COMP BOARD
U49450Medicare UPIN
C0768538OtherNYS WORKERS COMP BOARD