Demetrius C Zodiatis,MD.PC.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

119465

Legal business name

DEMETRIUS C ZODIATIS,MD.PC.

Practice address

1388 Stony Brook Rd
Stony Brook, NY 11790-2205

Phone

(631) 751-7588

Fax

(631) 689-3665

NPI assigned

Jul 6, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Demetrius Christos Zodiatis I, MD,FACP

Title

Ceo of Corporation

Phone

(631) 751-7588

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309910400000",
    "number": "1558658989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1388 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902205",
            "telephone_number": "631-751-7588",
            "fax_number": "631-689-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1388 STONY BROOK RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902205",
            "telephone_number": "631-751-7588",
            "fax_number": "631-689-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMETRIUS C ZODIATIS,MD.PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A",
        "authorized_official_last_name": "ZODIATIS",
        "authorized_official_first_name": "DEMETRIUS",
        "authorized_official_middle_name": "CHRISTOS",
        "authorized_official_title_or_position": "CEO OF CORPORATION",
        "authorized_official_telephone_number": "631-751-7588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "MD,FACP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": "119465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edin Delimustafic, RPA-C
• Jaclyn Delpozzo-Richards
• Benjamin Charles Delucia, M.D.
• Daniel Vincent Anthony Demarco, PA-C
• Dominick Demarco, PT, DPT
• Tinsae Demissie, MD
• Thomas Demundo, PHARM.D.
• Ryan Denis
• Paula Irina Denoya, MD
• Jonathan Herbert Derlath, DMD

• Primary Care Clinic/Center in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.