Provider Demographics
NPI:1518183938
Name:MELISARATOS, DARIUS PARIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:PARIS
Last Name:MELISARATOS
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:C/O PRECISION RADIOLOGY
Mailing Address - Street 2:345 SEAVIEW AVE.
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2244
Mailing Address - Country:US
Mailing Address - Phone:718-980-4888
Mailing Address - Fax:718-980-4873
Practice Address - Street 1:699 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4244
Practice Address - Country:US
Practice Address - Phone:201-836-2500
Practice Address - Fax:201-836-0083
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05511500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF35005Medicare UPIN