THEODORA PANTELOGLOU D.O.
NPI 1487661401
Pediatrics in Bayside, NY

Active since August 02, 2006CLIA 33D2002993 · Waiver
21430 46TH AVE, BAYSIDE, NY 11361(718) 229-1064(718) 423-2924 Get Directions Write a Review

NPPES record last updated: March 27, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Theodora Panteloglou D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORA PANTELOGLOU D.O. (NPI 1487661401) is an individual pediatrics provider in Bayside, New York, licensed in New York (222871) and active in the NPI registry since August 2006. She holds a CLIA Waiver certificate valid through January 28, 2028.

NPPES Registry Identity

NPI1487661401
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTHEODORA PANTELOGLOUCredential: D.O.
Location Address21430 46TH AVEBayside, NY 11361-3316
Mailing Address6 Orchard PlValley Stream, NY 11580-5003 · (516) 285-8219
Fax(718) 423-2924
Sole ProprietorYes
Enumeration DateAugust 2, 2006
Last NPPES UpdateMarch 27, 2008
NPI 1487661401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License Licensed in NY · 222871
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

21430 46TH AVE, Bayside, NY 11361

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
33D2002993
Facility Type
Physician Office
Certificate Effective Date
January 29, 2026
Certificate Expiration Date
January 28, 2028
Laboratory Director
MR. THEODORA PANTELOGLOU
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Theodora Panteloglou to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487661401, enumerated as an "individual" on August 02, 2006.

The provider is located at 21430 46TH AVE BAYSIDE, NY 11361 and the phone number is (718) 229-1064.

Pediatrics with taxonomy code 208000000X.