Healthcare Provider Details

I. General information

NPI: 1992875173
Provider Name (Legal Business Name): JOHN K AIDONIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JANI AJDHONI MD

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 E POST RD
WHITE PLAINS NY
10601-4607
US

IV. Provider business mailing address

PO BOX 551420
FORT LAUDERDALE FL
33355-1420
US

V. Phone/Fax

Practice location:
  • Phone: 914-428-5454
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax: 855-851-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number60-274868
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME145956
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: