Provider Demographics
NPI:1629391495
Name:ULYSSES SCARPIDIS, M.D., P.C.
Entity Type:Organization
Organization Name:ULYSSES SCARPIDIS, M.D., P.C.
Other - Org Name:ULYSSES SCARPIDIS, M.D., P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ULYSSES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCARPIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-667-6631
Mailing Address - Street 1:400 E 66TH APT 11D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:917-667-6631
Mailing Address - Fax:908-464-6711
Practice Address - Street 1:140 BERGEN ST
Practice Address - Street 2:SUITE E1620
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2425
Practice Address - Country:US
Practice Address - Phone:917-667-6631
Practice Address - Fax:908-464-6711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY245842-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty