DEMETRIUS C ZODIATIS,MD.PC.


Address: 1388 Stony Brook Rd, Stony Brook, NY 11790-2205
Phone: 6317517588

DEMETRIUS C ZODIATIS,MD.PC. (NPI# 1558658989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1558658989
Entity Type Organization
Organization Name DEMETRIUS C ZODIATIS,MD.PC.
Practice Address 1388 Stony Brook Rd
Stony Brook
NY 11790-2205
Practice Telephone 6317517588
Practice Fax Number 6316893665
Mailing Telephone 6317517588
Mailing Fax Number 6316893665
Enumeration Date 2011-07-06
Last Update Date 2011-07-06
Authorized Official Name DR. DEMETRIUS CHRISTOS ZODIATIS I (CEO OF CORPORATION)
Authorized Official Telephone 6317517588
Authorized Official Credential MD,FACP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
119465 Ambulatory Health Care Facilities

Office Location

Street Address 1388 STONY BROOK RD
City STONY BROOK
State NY
Zip Code 11790-2205

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1649807678 Ribu Mathew Student in an Organized Health Care Education/Training Program Health Science Center T16, Room 020, Stony Brook, NY 11790 2020-03-27
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1972022234 Carol M Doherty Specialist 7 Haskel Lane, Stony Brook, NY 11790 2017-09-18
1972021582 Louren M Gonzales Nurse Practitioner 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 2017-09-04
1043740954 Asma Khattak Behavior Technician 90 Quaker Path, Stony Brook, NY 11790 2017-06-13
1427452846 Christina Georgia Registered Nurse 36 Ivy League Lane, Stony Brook, NY 11790 2014-10-14
1124361654 Mandeep Kainth Student in an Organized Health Care Education/Training Program Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 2013-04-03
1922357144 Audry M Luciano Registered Nurse 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 2012-09-04
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851570196 Eastern Medical Care of Suffolk County, P.C. Clinic/Center 215 Hallock Rd Ste 3a, Stony Brook, NY 11790-3077 2007-11-02
1548555493 Suffolk Medical Care, P.C. Clinic/Center 2500 Nesconset Hwy, Bldg 12-c, Stony Brook, NY 11790-2555 2011-06-17

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1417509357 Henderson Health Services Family Nurse Practitioner Pllc Clinic/Center 4 Clarion Dr, White Plains, NY 10603-2868 2019-07-11
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Competitor

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City STONY BROOK
Zip Code 11790

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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