Provider Demographics
NPI:1114971306
Name:ASTORIA HEALTHCARE ASSOCIATES LLP
Entity Type:Organization
Organization Name:ASTORIA HEALTHCARE ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTAKOURIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-545-2020
Mailing Address - Street 1:3010 38TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3804
Mailing Address - Country:US
Mailing Address - Phone:718-545-2020
Mailing Address - Fax:718-932-9131
Practice Address - Street 1:3010 38TH ST FL 2
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3804
Practice Address - Country:US
Practice Address - Phone:718-545-2020
Practice Address - Fax:718-932-9131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07400Medicare ID - Type Unspecified