Provider Demographics
NPI:1861521239
Name:FLORAKIS, GEORGE JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JAMES
Last Name:FLORAKIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:110 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5136
Mailing Address - Country:US
Mailing Address - Phone:914-723-1641
Mailing Address - Fax:914-723-5468
Practice Address - Street 1:110 BROOK ST
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5136
Practice Address - Country:US
Practice Address - Phone:914-723-1641
Practice Address - Fax:914-723-5468
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158585-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA03362Medicare UPIN
NY23E351Medicare ID - Type UnspecifiedNEW YORK CITY
NYWEU291Medicare PIN
NY23E352Medicare ID - Type UnspecifiedSCARSDALE, NY