Healthcare Provider Details

I. General information

NPI: 1659670776
Provider Name (Legal Business Name): ARISTOTLE PANAYIOTOPOULOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 11/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 HYLAN BLVD PEDIATRIC ENDOCRINOLOGY
STATEN ISLAND NY
10306-3117
US

IV. Provider business mailing address

2460 HYLAN BLVD PEDIATRIC ENDOCRINOLOGY
STATEN ISLAND NY
10306-3117
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-5619
  • Fax: 718-226-5620
Mailing address:
  • Phone: 718-226-5619
  • Fax: 718-226-5620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number262036
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: