Constantine Demetriadis, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

004077 Issued in NY

Practice address

420 5TH Ave FL 7
New York, NY 10018-0223

Phone

(646) 682-5343

NPI assigned

Feb 19, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1659549061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 5TH AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100180223",
            "telephone_number": "646-682-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 5TH AVE FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100180223",
            "telephone_number": "646-682-5343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Old Orangeburg Rd",
            "address_purpose": "LOCATION",
            "city": "Orangeburg",
            "state": "NY",
            "postal_code": "109621166",
            "country_code": "US",
            "telephone_number": "850-322-0978",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 W Brooks St",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730191018",
            "country_code": "US",
            "telephone_number": "405-325-8001",
            "fax_number": "405-325-8388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "845 Lake Markham Rd",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "FL",
            "postal_code": "32771",
            "country_code": "US",
            "telephone_number": "850-322-0978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMETRIADIS",
        "first_name": "CONSTANTINE",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-19",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL1917",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "004077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetra Hamakiotes LLC
• Constantine Antony Demetracopoulos, M.D.
• James Peter Demetri, LCSW, DDS
• Alina S. Demetria, M.A., CF - SLP
• Anna Maria Demetriades, M.D., PH.D.
• Victor Demetrio, DO
• Nicholas Demetriou, ANP
• Susan Marie Demetropolis, M.A.
• Elizabeth G Demicco, MD, PHD.
• Annette Demichele, PH.D., J.D.

• Athletic Trainer in New York, NY
• Providers in New York, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.