MEDICARE: SOTERIOS C PHILIPPOU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	130214	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467501163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOTERIOS C PHILIPPOU M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1529
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-7529
Country	:	US
Telephone Number	:	516-629-2484
Fax Number	:	516-629-2027

Provider Business Practice Location Address
First Line	:	100 PORT WASHINGTON BLVD
Second Line	:
City	:	ROSLYN
State	:	NY
Zip	:	11576-1353
Country	:	US
Telephone Number	:	516-629-2484
Fax Number	:	516-629-2027

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	06/07/2026

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Directions to “ SOTERIOS C PHILIPPOU M.D.” Practice Location

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