MEDICARE: DR. ARGIRIOS MANTZOUKAS

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	N006060	NY

General Provider Information

NPI Number	:	1134297542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARGIRIOS MANTZOUKAS

Provider Business Mailing Address
First Line	:	8607 21ST AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4003
Country	:	US
Telephone Number	:	718-266-1986
Fax Number	:	718-266-2203

Provider Business Practice Location Address
First Line	:	8635 21ST AVE APT 1C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4033
Country	:	US
Telephone Number	:	171-826-6198
Fax Number	:	718-266-2203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	03/25/2024

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