Theodorou Plastic Surgery, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

228653-1 Issued in NY

Legal business name

THEODOROU PLASTIC SURGERY, PC

Practice address

128 Central Park S
New York, NY 10019-1565

Phone

(914) 237-6797

Fax

(914) 237-6790

NPI assigned

Sep 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Spero John Theodorou, MD

Title

Director

Phone

(914) 237-6797

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1871692434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 MCLEAN AVE",
            "address_2": "SUITE 387",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107044105",
            "telephone_number": "914-237-6797",
            "fax_number": "914-206-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 CENTRAL PARK S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191565",
            "telephone_number": "914-237-6797",
            "fax_number": "914-237-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODOROU PLASTIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "THEODOROU",
        "authorized_official_first_name": "SPERO",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "914-237-6797",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "228653-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "228653-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Eugenia Theodore, MD MPH
• Nicole Theodore, LMSW
• Sathya Theodore, M.D.
• Anna Theodoridis, NP
• Kleanthis Theodoropoulos, M.D. , PHD
• Spero John Theodorou, M.D.
• Eugenia Theodosopoulos
• Sophia Theoklitos, PA-C
• Teresa Theophano, LCSW
• Parisa Thepmankorn

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.