Provider Demographics
NPI:1083633218
Name:ANAGNOSTOPOULOS, ANASTASIA C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANASTASIA
Middle Name:C
Last Name:ANAGNOSTOPOULOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANASTASIA
Other - Middle Name:M
Other - Last Name:ANAGNOSTOPOULOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:33 PEPPERMILL RD
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3105
Mailing Address - Country:US
Mailing Address - Phone:516-747-7389
Mailing Address - Fax:516-747-2844
Practice Address - Street 1:100 PORT WASHINGTON BLVD
Practice Address - Street 2:ST FRANCIS HOSPITAL PATHOLOGY DEPT
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-1353
Practice Address - Country:US
Practice Address - Phone:516-562-6413
Practice Address - Fax:516-562-6427
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143772-1207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY18I431Medicare ID - Type Unspecified
NYF76829Medicare UPIN