Basic Information
| Provider Information | |||||||||
| NPI: | 1063643641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PANTELIDES | ||||||||
| FirstName: | HARRY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2625 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100098925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142220828 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112118755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186189181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2009 | ||||||||
| LastUpdateDate: | 09/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 254266 | NY | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.