Healthcare Provider Details

I. General information

NPI: 1346445806
Provider Name (Legal Business Name): ANASTASIOS PELIAS, M.D.,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2094 ELLIOT ST
MERRICK NY
11566-5004
US

IV. Provider business mailing address

2094 ELLIOT ST
MERRICK NY
11566-5004
US

V. Phone/Fax

Practice location:
  • Phone: 516-670-0212
  • Fax:
Mailing address:
  • Phone: 516-670-0212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number217926
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number217926
License Number StateNY

VIII. Authorized Official

Name: ANASTASIOS PELIAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 516-670-0212