Provider Demographics
NPI:1073867586
Name:CHRISTOS I. STAVROPOULOS, MD, PC
Entity Type:Organization
Organization Name:CHRISTOS I. STAVROPOULOS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOS
Authorized Official - Middle Name:I
Authorized Official - Last Name:STAVROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-363-5454
Mailing Address - Street 1:39 VESTRY ST
Mailing Address - Street 2:APT. #1-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1766
Mailing Address - Country:US
Mailing Address - Phone:917-363-5454
Mailing Address - Fax:
Practice Address - Street 1:39 VESTRY ST
Practice Address - Street 2:APT. #1-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-1766
Practice Address - Country:US
Practice Address - Phone:917-363-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230175-1208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty