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NPI Code Detail

MEDICARE: DR. MIKE M PAPPAS D.O.

MEDICARE: DR. MIKE M PAPPAS D.O.
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
1204D00000XNeuromusculoskeletal Medicine & OMM Physician222059NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00319546OTHERNYRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1538132154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKE M PAPPAS D.O.
Provider Business Mailing Address
First Line : PO BOX 1795
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-0468
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1274 E MAIN ST
Second Line :
City : RIVERHEAD
State : NY
Zip : 11901-2583
Country : US
Telephone Number : 631-591-0840
Fax Number : 631-591-0841
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 06/03/2014

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