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NPI Code Detail

MEDICARE: JOHN STAMATOS M.D.

MEDICARE: JOHN STAMATOS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine PhysicianA195317NY
2208VP0014XInterventional Pain Medicine PhysicianA195317NY
3207L00000XAnesthesiology PhysicianA195317NY
4207LC0200XCritical Care Medicine (Anesthesiology) PhysicianA195317NY
5207LP2900XPain Medicine (Anesthesiology) PhysicianA195317NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083610992
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN STAMATOS M.D.
Provider Business Mailing Address
First Line : 68 S SERVICE RD
Second Line : SUITE 350
City : MELVILLE
State : NY
Zip : 11747-2354
Country : US
Telephone Number : 516-945-3000
Fax Number :
Provider Business Practice Location Address
First Line : 221 JERICHO TPKE
Second Line :
City : SYOSSET
State : NY
Zip : 11791-4515
Country : US
Telephone Number : 516-496-6558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2005
Last Update Date : 12/15/2010

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