Provider Demographics
NPI:1881955706
Name:KROMMIDAS, MARIA LO (MSED)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LO
Last Name:KROMMIDAS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2348 CHARING CROSS RD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3006
Mailing Address - Country:US
Mailing Address - Phone:917-494-5787
Mailing Address - Fax:516-208-7796
Practice Address - Street 1:2348 CHARING CROSS RD
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-3006
Practice Address - Country:US
Practice Address - Phone:917-494-5787
Practice Address - Fax:516-208-7796
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist