Healthcare Provider Details

I. General information

NPI: 1205815727
Provider Name (Legal Business Name): CHRISTOS DEAN DOSSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 VICTORY BLVD
STATEN ISLAND NY
10301-3621
US

IV. Provider business mailing address

PO BOX 827 LENOX HILL STATION
NEW YORK NY
10021-0008
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-7927
  • Fax: 718-667-7897
Mailing address:
  • Phone: 718-667-7927
  • Fax: 718-667-7897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number193806
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: