Healthcare Provider Details

I. General information

NPI: 1295729457
Provider Name (Legal Business Name): JOHN PAPPAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 32ND ST
NEW YORK NY
10016-6004
US

IV. Provider business mailing address

145 E 32ND ST PH (14TH FLOOR)
NEW YORK NY
10016-6055
US

V. Phone/Fax

Practice location:
  • Phone: 646-754-2222
  • Fax: 646-754-2250
Mailing address:
  • Phone: 646-754-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SM0001X
TaxonomyMolecular Genetic Pathology (Medical Genetics) Physician
License Number182592
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: