Provider Demographics
NPI:1205055209
Name:AMP MEDICAL DIAGNOSTICS LLP
Entity type:Organization
Organization Name:AMP MEDICAL DIAGNOSTICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:COSMATOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-726-0133
Mailing Address - Street 1:2747 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3142
Mailing Address - Country:US
Mailing Address - Phone:718-726-0133
Mailing Address - Fax:718-726-7385
Practice Address - Street 1:2747 CRESCENT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3142
Practice Address - Country:US
Practice Address - Phone:718-726-0133
Practice Address - Fax:718-726-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty