Provider Demographics
NPI:1790737948
Name:LAINIOTIS, JAMES THEODORE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THEODORE
Last Name:LAINIOTIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:654 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4911
Mailing Address - Country:US
Mailing Address - Phone:516-938-1414
Mailing Address - Fax:516-938-4659
Practice Address - Street 1:654 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4911
Practice Address - Country:US
Practice Address - Phone:516-938-1414
Practice Address - Fax:516-938-4659
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00965811Medicaid
NY00965811Medicaid
NYD37999Medicare UPIN