Provider Demographics
NPI:1518043272
Name:CHRISTOUDIAS, GEORGE CHRISTOS (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:CHRISTOS
Last Name:CHRISTOUDIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:17 LOWER CROSS RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-3206
Mailing Address - Country:US
Mailing Address - Phone:201-833-2888
Mailing Address - Fax:201-833-1010
Practice Address - Street 1:741 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4243
Practice Address - Country:US
Practice Address - Phone:201-833-2888
Practice Address - Fax:201-833-1010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03319000208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3006301Medicaid
NJE70682Medicare ID - Type Unspecified