Provider Demographics
NPI:1699919969
Name:PAPANTONIOU, KALEROY (MD)
Entity type:Individual
Prefix:
First Name:KALEROY
Middle Name:
Last Name:PAPANTONIOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 WALT WHITMAN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2215
Mailing Address - Country:US
Mailing Address - Phone:631-377-7222
Mailing Address - Fax:631-621-5021
Practice Address - Street 1:900 WALT WHITMAN RD STE 101
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2215
Practice Address - Country:US
Practice Address - Phone:631-377-7222
Practice Address - Fax:631-621-5021
Is Sole Proprietor?:No
Enumeration Date:2009-04-29
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253792207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology