Provider Demographics
NPI:1528490455
Name:VLACHOSTERGIOS, PANAGIOTIS (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PANAGIOTIS
Middle Name:
Last Name:VLACHOSTERGIOS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 6TH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3648
Mailing Address - Country:US
Mailing Address - Phone:718-780-5824
Mailing Address - Fax:718-780-5545
Practice Address - Street 1:340 4TH AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2718
Practice Address - Country:US
Practice Address - Phone:718-643-0483
Practice Address - Fax:718-855-4396
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285274207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine