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Gina Mavroudis

Specialist

Other Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Gina Mavroudis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1508280686
Provider Type
Individual
Full Name
Mavroudis, Gina
Credential
MASTERS

Gender
Female
Sole Proprietor
No
Enumeration Date
2/11/2014
Last Updated
2/11/2014

Contact Information

Practice Location

7616 13th Ave, Brooklyn, NY 11228-2412

(718) 921-0606

Unlisted Fax

Mailing Location

1263 80th St, Brooklyn, NY 11228-2711

(917) 559-7999

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 121787354	Description Medicaid	Issuer Unlisted New York

Gina Mavroudis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Gaynullina, Elvira

Diamantakos, Natalia

Michelle Carissimi Llc

Concepcion, Melissa

Kelly, Elizabeth

Kokkinos, Evangelia

Messina, Christina Rose

Santana, Gabrielle Alicea

Parcell, Laura Ann

Rosenberg, Jennifer Marien