MEDICARE: DR. JOSEPH MATTHEW ARTOGLOU

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	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	045404-01	NY
2	225100000X	Physical Therapist	045404	NY

General Provider Information

NPI Number	:	1346888922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MATTHEW ARTOGLOU

Provider Business Mailing Address
First Line	:	60A BAY ST
Second Line	:
City	:	SAG HARBOR
State	:	NY
Zip	:	11963-3106
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60A BAY ST
Second Line	:
City	:	SAG HARBOR
State	:	NY
Zip	:	11963-3106
Country	:	US
Telephone Number	:	631-725-4450
Fax Number	:

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

Provider Enumeration Date	:	12/14/2019
Last Update Date	:	07/09/2021

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