Provider Demographics
NPI:1467471854
Name:GASPARIS, ANTONIOS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIOS
Middle Name:
Last Name:GASPARIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743
Mailing Address - Country:US
Mailing Address - Phone:631-470-1460
Mailing Address - Fax:
Practice Address - Street 1:175 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743
Practice Address - Country:US
Practice Address - Phone:631-470-1460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2196172086S0129X
NY2173442086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7145455OtherAETNA
NY02406499Medicaid
NY0N8282OtherEMPIRE BC.BS
NY0N8282OtherEMPIRE BC.BS
NYI00778Medicare UPIN