Provider Demographics
NPI:1245534072
Name:GIAMOS, VICTOR (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:GIAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:186 OLD TOWN RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5013
Mailing Address - Country:US
Mailing Address - Phone:631-265-8780
Mailing Address - Fax:631-257-5098
Practice Address - Street 1:100 MOTOR PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5138
Practice Address - Country:US
Practice Address - Phone:631-265-8780
Practice Address - Fax:631-257-5098
Is Sole Proprietor?:No
Enumeration Date:2011-01-09
Last Update Date:2017-02-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY60 254305207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400067768Medicare PIN
NYJ400191644Medicare UPIN