Provider Demographics
NPI:1902000458
Name:CHRISTOS STAVROPOULOS, MD PC
Entity Type:Organization
Organization Name:CHRISTOS STAVROPOULOS, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CODING
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN CCSP
Authorized Official - Phone:845-634-6500
Mailing Address - Street 1:36 7TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6609
Mailing Address - Country:US
Mailing Address - Phone:646-483-0934
Mailing Address - Fax:
Practice Address - Street 1:17 SQUADRON BLVD
Practice Address - Street 2:400
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5214
Practice Address - Country:US
Practice Address - Phone:845-634-6500
Practice Address - Fax:845-634-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230175208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY553P71Medicare ID - Type Unspecified