Provider Demographics
NPI:1053714410
Name:CHATZICHARALAMPOUS, CHARALAMPOS (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CHARALAMPOS
Middle Name:
Last Name:CHATZICHARALAMPOUS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 BROADWAY FL 14
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2516
Mailing Address - Country:US
Mailing Address - Phone:212-348-4000
Mailing Address - Fax:
Practice Address - Street 1:65 BROADWAY FL 14
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2516
Practice Address - Country:US
Practice Address - Phone:212-348-4000
Practice Address - Fax:212-348-4001
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278684207SG0201X, 207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology