Antoun Saba Mitromaras, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

185255 Issued in NY

Practice address

509 Route 112
Port Jefferson Station, NY 11776

Phone

(631) 331-1100

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1841263274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 PATCHOGUE RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761006",
            "telephone_number": "631-331-1100",
            "fax_number": "631-331-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ROUTE 112",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-331-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITROMARAS",
        "first_name": "ANTOUN",
        "middle_name": "SABA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "185255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usman Mirza, MD, MBA
• Haim Misholy, M.D.
• Lorene Margaret Mistretta, R.N.
• Eric Ira Mitchnick, MD
• Jacquelyn Mitra
• Leanne Mary Molia, M.D.
• Lauren Monroe, MS, NCSP
• Jill Monte
• Anthony Monteforte
• Anne Marie Montijo, LCSW

• Family Medicine Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.