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General NPI Number Information
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NPI Number | 1073867586
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Entity Type | Organization
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Legal Business Name | CHRISTOS I. STAVROPOULOS, MD, PC
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 10/11/2013
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Provider Practice Location Address
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Address Line | 39 VESTRY ST APT. #1-A
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City | NEW YORK
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State | NY
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Zip | 10013-1766
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Country | US
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Telephone | 917-363-5454
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Fax |
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Provider Business Mailing Address
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Address Line | 39 VESTRY ST APT. #1-A
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City | NEW YORK
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State | NY
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Zip | 10013-1766
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Country | US
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Telephone | 917-363-5454
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHRISTOS I. STAVROPOULOS
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Credential | M.D.
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Telephone | 917-363-5454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 230175-1
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License Number State | NY
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